Ultrasound evaluation of breast cysts

Last revised by Andrew Murphy on 23 Mar 2023

Ultrasound evaluation of breast cysts is the modality of choice. Obstruction of the ducts, often appearing as the result of epithelial hyperplastic processes or stromal fibrosis, or both processes lead to the formation of cysts, disabling the drainage of the terminal ducts of the lobules.

In almost 70% of all fibrocystic change, the cysts represent the predominant finding.

According to size, the cysts are divided into two categories:

  1. macrocysts: ranging from 1-6 cm in diameter that could be simple cysts or lobulated multilocular lesions
  2. microcysts: <3 mm in diameter

Cysts can be:

  • solitary lesions
  • multiple lesions

Based on the structure, cysts can be divided into two groups:

  • typical cysts with characteristic echographic appearance
    • anechoic
    • sonolucent round lesions
    • well contoured with posterior enhancement
  • atypical cysts with all the features of typical cysts with
    • more or less subtle echoes within the anechoic cyst
    • proliferations
    • calcifications

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Cases and figures

  •  Case 1
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