By DR DUANGMANI THANAPPRAPASR
Common in women over 30 years of age, breast cysts are fluid-filled sacs within the breast. A woman may have a single cyst or many cysts and these are often described as round with distinct edges.
A large cyst can be felt in the breast and usually feels like a soft grape or a water-filled balloon. The cysts usually disappear after menopause, except in cases where the women are taking hormone therapy.
Symptoms of breast cysts include:
A smooth, easily movable round breast lump with distinct edges
Breast pain in the area of the breast lump
Increase in breast lump size and tenderness just before the period, and decrease in breast lump size after the period
One important thing to know is that a simple cyst does not increase the risk of developing breast cancer. If you detect the presence of any new breast lumps or if an already identified breast lump seems to have grown, please seek medical attention in order to get it checked out.
Each of the breasts contains 15-20 lobes of glandular tissue. The lobes are further divided into smaller lobules that produce milk. Ducts then carry the produced milk. Breast cysts develop when an overgrowth of glands and connective tissue blocks the milk ducts, causing them to widen and fill with fluid.
Microcysts are too small to feel, but will be seen during such imaging tests as mammography or ultrasound.
Macrocysts are large enough to be felt. Most of them can be clearly felt at 2.5 centimetres. Large cysts can put pressure on nearby breast tissue, causing breast pain.
The cause of breast cysts remains unknown but it is believed they may be the result of excess oestrogen in the body. Screening and diagnosis of a breast cyst usually begins after a breast lump is identified by you or a doctor: The process will incorporate the following steps.
The doctor will physically examine the breast. However, this breast examination cannot identify whether a breast lump is fluid-filled or solid and other tests will be needed.
A breast ultrasound can help the doctor determine whether a breast lump is fluid-filled or solid.
Fine-needle aspiration is performed. The doctor inserts a needle into the breast lump and withdraws fluid. If the fluid is not bloody, no further testing is needed. If the fluid appears bloody, the doctor will send a sample of the fluid for lab testing. If no fluid is withdrawn or the breast lump does not disappear, it suggests that the breast lump or a portion of it is solid and a sample of cells will be sent for analysis to check for cancer.
No treatment is necessary for simple breast cysts. The doctor may recommend closely monitoring a breast cyst to see if its size changes.
There are three treatment options
The fine-needle aspiration procedure, which is used to diagnose a breast cyst also serves as treatment when the doctor removes all the fluid from the cyst resulting in the breast lump disappearing and the symptoms clearing up. The doctor will locate the position of the breast cyst and insert a needle to withdraw fluid. For more accuracy, ultrasound will be used to guide the accurate placement of the needle. After the fluid has been withdrawn from a breast cyst, a recurrence or new cysts are very common.
Hormone use: Using birth control pills to regulate the menstrual cycles may help reduce the recurrence of breast cysts. Discontinuing hormone replacement therapy during the postmenopausal years may reduce the formation of cysts as well.
Surgery: In some cases, the surgical removal of cyst is necessary. Surgery may be considered for an uncomfortable breast cyst or if a breast cyst contains blood-tinged fluid or shows other worrisome signs of cancer.
For prevention of breast cysts, you should wear a well-fitted and supportive bra to help relieve some discomfort. Avoid coffee. While there is no scientific proof that coffee consumption is linked to breast cysts, some women find relief from their symptoms after stopping coffee consumption. Reducing salt in the diet is also recommended because sodium increases the congestion of excess fluid retained by the body.
A breast self-examination should be done at least once each month. In case of finding any abnormality, seek immediate medical attention.
DR DUANGMANI THANAPPRAPASR is an Obstetrics-Gynaecologist attached to the Women’s Health Centre at Samitivej Sukhumvit Hospital. Call (02) 711 8555-6.