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Complex breast cyst

Dr Jeremy Jones and Radswiki et al.

A 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.