Breast Cyst

Many women experience breast cysts at some point in their lives. Dealing with this issue can be confusing and frightening. In this article, we will discuss what a breast cyst is, its types, causes, symptoms, and appropriate treatment options.

What is a Breast Cyst?

A fluid-filled sac that forms in the breast tissues is referred to as a breast cyst. They are usually lumps that appear round or oval and have well-defined edges; they can easily move around within the breast tissue. Typically, the fluid within these cysts is clear, yellow, brown, or blackish.

Breast cysts are almost always benign (not cancerous) and typically do not increase a woman’s chances of getting breast cancer. Nevertheless, detecting new masses in the breast may be difficult with certain types of breast cysts. That’s why it’s important for you to know your breasts and be aware of any changes.

Types of Breast Cysts

The two major types of breast cysts include;

• Microcysts
  • These small cysts can only be seen through imaging tests, such as mammography.
  • They cannot be felt during a self-breast examination by hand.
• Macrocysts
  • Macrocysts are larger lumps in the breasts.
  • Usually it’s about an inch or two across.
  • However, if left untreated, they may grow larger over time.

Symptoms of Breast Cysts

The most common signs of a breast cyst include:

• A smooth, round, easily movable breast lump, often with distinct edges.
• Breast pain or tenderness around the area of the lump.
• Nipple discharge that may be clear, yellow, brown, or black.
• Increase in breast lump size and tenderness before menstruation.
• Decrease in lump size and relief of symptoms after menstruation.

Many breast cysts do not cause any symptoms at all and may be found incidentally during an imaging test. However, a large or inflamed cyst may be uncomfortable. Tracking any breast changes is important.

Causes of Breast Cysts

Experts are not entirely sure what causes breast cysts to develop, but research shows hormonal influences play a key role. The hormonal changes of the menstrual cycle may contribute to breast cysts in premenopausal women.

Breast cysts also frequently develop in postmenopausal women who use hormone replacement therapy (HRT). The additional oestrogen circulates through the body and can stimulate breast cell growth.

Other factors linked to Breast Cyst Development include:

• Family history
• Smoking
• Birth control use
• High caffeine/alcohol intake
• High-fat diet

Diagnosis

If you discover a new breast lump or have symptoms of a possible breast cyst, the first step is scheduling an appointment with your healthcare provider. Be prepared to give a full description of the breast changes you are experiencing.

Your doctor will ask about your symptoms and medical history and perform exam tests:

• Physical breast exam: Feeling for lumps, changes in breast shape, or skin dimpling.
• Mammogram: An X-ray to visualise breast tissue.
• Breast ultrasound: Uses sound waves to create images of breast structures.
• Fine needle aspiration: This involves inserting a thin needle into the breast lump to draw out fluid for examination under a microscope. This test helps determine if the lump is a benign cyst or a potentially cancerous mass.

Your doctor may also order blood tests to evaluate hormone levels or to rule out other medical conditions.

Treatment

Many breast cysts do not require any treatment if they are not causing symptoms. Your healthcare provider may recommend watchful waiting, which involves monitoring the cyst over several menstrual cycles to see if it goes away on its own.

If a cyst persists over two to three cycles or becomes large and painful, your doctor may recommend:

• Cyst Drainage 
  • Also called aspiration, a doctor inserts a needle into the breast cyst and drains out the fluid. 
  • This helps relieve symptoms rapidly, but cysts can sometimes reaccumulate fluid over time.
• Hormonal Treatments 
  • Birth control pills may help stabilise hormone fluctuations, reducing cyst recurrence. 
  • Discontinuing hormone replacement therapy often eliminates cysts as well.

Certain dietary modifications and supplements may help minimise cyst recurrence for some women too. However, before making any major changes, you must consult with your healthcare provider.

Surgery Treatment

Surgery is not usually the first choice for treating breast cysts, as most cysts are benign and can be managed without surgery. However, if a cyst causes persistent symptoms, is large, or raises concerns about cancer, surgical treatment may be considered. 

• Fine needle aspiration (FNA): This is a minimally invasive procedure where a thin needle is inserted into the cyst to drain fluid. FNA can provide immediate relief from symptoms and can also serve as a diagnostic tool by analyzing the fluid for signs of cancer.
• Surgical excision: If the cyst recurs despite aspiration, is complex, or if there's suspicion of cancer, surgical removal of the cyst may be recommended. This procedure involves making an incision over the cyst and removing it along with surrounding tissue. Surgical excision allows for a thorough examination of the cyst and surrounding tissue, providing a definitive diagnosis and treatment.
• Biopsy: In cases where there's uncertainty about the nature of the cyst, a biopsy may be performed. This involves removing a small sample of tissue from the cyst or surrounding area for examination under a microscope to determine if cancer is present.
• Lumpectomy or mastectomy: In rare cases where the cyst is associated with a larger area of abnormal tissue or if cancer is detected, more extensive surgical procedures such as lumpectomy (removal of the cyst and surrounding tissue) or mastectomy (removal of the entire breast) may be necessary.

Complications

While most breast cysts are benign, rarely they can cause complications such as:

• Infection - Bacteria enter the cyst or surrounding tissue through the needle during drainage. Signs include breast redness, swelling, and pain, requiring prompt antibiotic treatment.
• Cyst rupture - Cysts can sometimes break open on their own, causing pain and inflammation. Surgical drainage may be necessary.
• Fibrocystic breast changes - Some women develop many non-cancerous cysts as part of a broader condition called fibrocystic breast disease. While not dangerous, this causes recurrent pain and lumps. Hormonal treatments may help provide relief.
• Reaccumulation of fluid - After drainage, breast cysts can refill with fluid over time. Your doctor may recommend regular aspiration appointments or hormonal therapy to reduce cyst recurrence.

While extremely rare, some cysts may hide underlying breast cancer. Always follow your healthcare provider’s recommendations for ongoing monitoring and testing to confirm a cyst’s benign status. Catching breast cancer early leads to the best outcomes.

How do I Prevent Breast Cysts?

While breast cysts cannot always be completely prevented, certain lifestyle measures may help lower your risk:

• Maintain a healthy body weight.
• Choose hormone-free contraception, if possible.
• Limit alcohol and caffeine intake.
• Incorporate exercise into your routine.
• Reduce consumption of fat and animal-based foods in your diet.
• Take targeted supplements, such as evening primrose oil.

Being aware of how your breasts normally look and feel can help you identify any new or unusual changes for prompt evaluation. Familiarise yourself with the typical signs of breast cysts for comparison as well.

When to See a Doctor

Schedule an appointment with your healthcare provider if you notice any of the following breast changes:

• A new lump that persists for two or more menstrual cycles.
• Sudden nipple discharge.
• Breast warmth, redness, pain, and swelling.
• A lump that continues growing larger.
• Changes to breast size or shape.
• Dimpling, irritation, or scaliness of breast skin.

Breast cysts can sometimes mask more serious conditions, such as breast cancer. Getting evaluated quickly for any strange breast symptoms gives you the best chance of early detection and treatment if required.

Conclusion

Breast cysts commonly affect women but typically don't lead to major health issues or increase the risk of cancer when properly monitored by your healthcare team. There is no definitive way to prevent breast cysts completely, but lifestyle changes can lower your chances of developing them.

While frustrating and sometimes painful, breast cysts often resolve without intervention. In other cases, aspiration or hormonal therapy may be required for relief when cysts persist or recur. Prompt evaluation of new breast lumps allows confirmation of the cyst's benign status as well.

Know what's normal for your breasts and be aware of any unusual changes. Schedule prompt medical assessment for concerning symptoms and stay in contact with your healthcare provider for continued follow-up to ensure overall breast health.

FAQs

1. Can a breast cyst turn into cancer?

Ans: Breast cysts are fluid-filled sacs that form in the breast tissue, usually due to hormonal influences. The vast majority of breast cysts are completely benign and non-cancerous. However, there is an extremely small risk that a cancerous tumour is hiding behind an apparent cyst, wrongly making it seem benign.

2. How long do breast cysts last?

Ans: Breast cysts can be intermittent or long-lasting. Many cysts resolve completely in one to two monthly cycles as hormone levels shift and return to normal. The fluid is simply reabsorbed into the surrounding tissue, and breast pain and swelling also improve.

3. Is cyst in breast harmful?

Ans: The vast majority of breast cysts are non-cancerous (benign) and do not increase the risk of breast cancer. They form as a result of hormonally-stimulated cell growth in the milk ducts of the breasts. Unless a simple cyst becomes excessively large, painful, or repeatedly infected, it typically doesn’t pose any major health issues.

4. What foods reduce breast cysts?

Ans: Research studying the effects of diet on breast cyst development is still quite limited at this time. No specific foods have been conclusively proven to prevent or reduce breast cysts thus far.

5. Is it normal to get breast cysts?

Ans: Breast cysts turn out to be surprisingly common. Estimates indicate that at least 1 out of every 3 women will deal with a benign breast cyst at some point in her life. However, despite being so widespread, many women panic after discovering an unexpected lump in their breasts.

6. Can a breast cyst be removed without surgery?

Ans: Yes, breast cysts can sometimes be drained without surgery using a fine needle aspiration (FNA) procedure performed by a healthcare professional.

7. Who treats breast cysts?

Ans: Breast cysts are typically treated by healthcare professionals specializing in breast health, such as breast surgeons, gynecologists, or breast radiologists.

8. Can a breast cyst cause shoulder pain?

Ans: Breast cysts themselves are unlikely to directly cause shoulder pain. However, if a cyst becomes large enough to press on surrounding tissues or nerves, it may cause referred pain in the shoulder area. It's essential to consult a healthcare provider to determine the cause of any shoulder pain.