Breast cysts are fluid filled sacs within the breast. Some women may have just one cyst and others may have multiple. The cysts often feel round, soft and have a distinctive globular margin. Sometimes the breast cyst is best described as a “soft grape.” Breast cyst is common in women in their 20s-30s. The majority of cysts disappear before the onset of menopause unless one is on sex hormone therapy. Most cysts require no treatment unless the lesion is painful, uncomfortable or very large. In such cases, fluid from the cyst can be aspirated and the symptoms disappear.
Breast cyst in a female is often discovered on a physical exam but some women may present with breast pain or tenderness. A breast cyst in rare cases may present as an unusual growth causing asymmetry of the breasts.
There are some cysts which are very small and may only be visible on ultrasound. Other cysts may be large enough to be felt by the hand. Experts believe that breast cysts causes include high estrogen levels in the body and blocked milk ducts.
The diagnosis of a cyst includes a physical exam and an ultrasound. Many physicians aspirate the cyst in their office. The aspiration is done with a local anesthetic and only takes a few minutes. Once the fluid is removed, the cyst disappears. No further treatment is necessary after the fluid is removed. However, if the fluid is bloody it is analyzed under the microscope. In general mammogram is not indicated for a breast cyst but the doctor may order one if there is a suspicion of something other than the cyst.
Some women may have recurrent cysts and may need to have the fluid drained more than once.
In some women with recurrence cysts, the doctor may start an oral contraceptive. It has been shown that regular use of the birth control pill can reduce cysts but the pills also have side effects like causing weight gain and blood clots in the legs. In women who are nearing menopausal, discontinuation of hormone replacement theory will reduce development of cysts.
The role of surgery for treatment of a breast cyst is unusual. Only the very large and suspicious cysts are ever operated upon. In some cases the cyst may have a bloody discharge which may be worrisome and surgery is indicated. The cyst is excised and sent for pathological evaluation.
There is no sure proof method of preventing cysts but one can reduce the symptoms. This involves wearing a support bra at night and during exercise. While there is no solid evidence that caffeine causes a breast cyst, most doctors recommend that females eliminate caffeine to reduce symptoms. Sometimes avoiding chocolates does help reduce development of cysts.
Manufactures of evening primrose oil claim that rubbing this oil on the breast can help relieve symptoms. In any case a breast cyst is not cancerous and should be treated conservatively. Needle aspiration of breast cysts is curative in most females.