DIAGNOSIS AND MANAGEMENT OF

BREAST CYSTS

By : ……………….
Supervisor : ……………….
 Introduction
• Cyst lesion of the breast  1 in 10 women
• The presence of cystic lesions of breast may prevent early discover of a small cancer

Treatment choice in the • Too radical and unjustified

past: simple mastectomy • Admision to hospital and surgery under general anesthesia
and wide excision
• Producing scars
• Easier to perform
Cyst Puncture • Does not necessitate general anesthesia
• Outpatient basis
• Could be repeated as often as necessary 2
• Leaves no scars
• Providing fluid for cytology and culture
 Clinical Findings
• Around 30 y.o – menopause, unless in exogenous estrogens
• Grow quickly and change with menstrual cycle
• Nonadherent
• Easily moved under the skin and over the depper structure
• Painful, especially before the menstruation
• Lacking of skin retraction, edema (orange skin), Limphadenopathy

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 Roentgenologic Findings
Mammogram

• Well delienated, round or ovoid masses

• Radioluscent line around the cyst
• No radiotactile ratio
• Air filled cysts

Fibroadenomas
• Lobulated and contain large,
densce calcification
Malignant
• Radiotactile ratio
• Thickening and retratction of the skin or nipple
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• Microcalsification
• Increased vascularity
 After aspiration, air
has been
Large, ovoid introduced. Note
mass, with that the wall of the
cyst is thin and
regular contour.
regular.

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 Technique
• Aseptic precaution
• Hold the mass between the thumb and forefinger of the other hand
• Introduce 21 gauge needle into the mass
• Aspirate the fluid
• Introduce an air with or without a drop of opaque medium into it
• Obtain roentnogram in profile view and superior inferior projection
• Ask patient to return to the department 1 month later and then twice a
year, unless a new mass detected.
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 Aspiration and
injection of air
demonstrate that it After introduction
is a simple cyst. of a few drops of
opaque medium:
thin coating gives
even better detail

Moderate size
mass somewhat
lost in the dense
breast. 7
 Results
• The air filled cyst appear as radiolucent
mass with thin and regular wall, which
are well defined and smooth
• After aspiration, there should be no
palpable mass remaining
• The fluid of cyst: straw colored (new) or
thicker and darker fluid which may be
brown or often green (old)

After filling with air the contours

appear very regular and thin,
A smaller tumor, the anterior border of 8
indicating a simple cyst.
which is not well defined.
 A tumor projecting from the
Very rarely, a tumor grows along the wall wall into the lumen, indicating
of the cyst, biopsy is obviously indicated malignant neoplasm. 9
 Discussion
• Cyst puncture is a simple procedure which time and money
saving
• Mammography helps to avoid errors, particularly in dysplastic
breasts that may be deceiving at palpation
• Displastic breast may be deceiving at palpation and a small
residual tumor may be not palpable after aspiration. But
these type or other cysts that were not palpable are
sometimes demonstrated by mammography
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 Conclusion

• Cyst puncture is an easy and accurate method which render

hospitalization and surgery under anesthesia unnecessary
• Mammography is of great value in arriving at a precise and
definitive diagnosis

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