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Complex breast cyst

Dr Ayush Goel and Radswiki et al.

Breast cyst may be simple, complicated, or complex (current prefered term is "solid and cystic" to avoid confusion with a complicated cyst).

Radiographic features

Breast ultrasound

Complicated cysts albeit well defined contain some low level internal echotexture or intra-cystic debris. The latter may layer and shift with changes in patient position. The homogeneous internal echoes within some complicated cysts may produce an appearance identical to that of a circumscribed solid mass. A complex or (solid and cystic) cyst does contain thick walls, thick septa, or other discrete solid-appearing component.

Significance

The risk of malignancy among complicated breast cysts is thought to be 0.3-2% and therefore it is often recommended these cysts can generally be managed with short-interval follow-up imaging or aspiration 1-2. It is important to differentiate a complicated breast cyst from a complex (solid and cystic) cyst, cystic breast mass, or an intracystic carcinoma of the breast, which will require biopsy.

Further work up

If the aspirated cyst contains bloody fluid it is often recommended to send to cytological analysis.

See also

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