Simple breast cyst

Case contributed by Henry Knipe

Presentation

Palpable right breast lump.

Patient Data

Age: 75 years
Gender: Female
mammography

Large well circumscribed mass in the right outer breast centrally. There is a complete low density halo which encircles the mass on both views. Note also that despite its large size it is not very dense. The density is similar to that of the surrounding fibroglandular tissue and the normal parenchymal elements are discernible through the mass.  These are reassuring morphologic features. 

Nonetheless, as it is a solitary mass, in the absence of prior imaging showing stability, it warrants further workup with ultrasound.

ultrasound

Hypoechoic mass without vascularity. On real time imaging the flowing internal echogenicity was present. There are multiple features of benignity - circumscribed margin, parallel ovoid shape and the presence of mobile cholesterol crystals producing typical color streaking on Doppler ultrasound.

ultrasound

The lesion was aspirated to dryness using a 19G needle with approximately 5 mL of yellow fluid aspirated. 

Case Discussion

Typical imaging appearance of a benign breast cyst. 

Despite the reassuring mammographic appearances, a solitary circumscribed mass on mammogram should be further assessed unless prior imaging indicates stability.

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