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Breast cysts

  • 7% of women will develop a clinically palpable cyst
  • Usually occurs in perimenopausal women
  • Highest prevalence is 45-55 years
  • Cysts are often singular
  • May appear suddenly and are frequently painful
  • Require triple assessment
  • Initial treatment is by simple aspiration

Typical breast cyst fluid

  • Cytology should be performed if blood-stained aspirate
  • Consider excision if:
    • Cyst recurs rapidly or repeatedly
    • Residual lump after aspiration

Breast cyst pathology

Simple Apocrine
Lining epithelium Simple cuboidal Apocrine
Na / K ratio Less than 3 More than 3
pH Less than 7.4 More than 7.4
Tendency to recur Low Moderate
Association with cancer Not proven Possible

Bibliography

Berg W A,  Campassi C I,  Ioffe O B.  Cystic lesions of the breast:  sonographic pathologic correlation.  Radiology 2003;  227;  183-191
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