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Complex breast cyst

Dr Henry Knipe and Radswiki et al.

Breast cysts may be simple, complicated, or complex. The current preferred term for complex breast cysts is "solid and cystic mass" 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 cyst (solid and cystic mass) does contain thick walls, thick septa, or other discrete solid-appearing component.

Treatment and prognosis

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.

Related articles

Breast imaging and pathology

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