IS Case 432: Simple breast cyst in a lactating patient
Imaging Sciences URMC 2010
Publication Date: 2010-08-27
Ultrasound demonstrated a circumscribed, round or oval anechoic structure with imperceptible wall and posterior acoustic enhancement. Mammography demonstrated a circumscribed mass with hypo- or isodense to the parenchyma and possible obscured margin secondary to surrounding tissue.
Cysts can occur throughout the breasts. They may be secondary to obstructed ducts, enlarge with estrogen exposure and fluctuate during the menstrual cycle. Cysts are line by epithelium and are fluid-filled. They range from microscopic size, up to several centimeters.
Ultrasound (US) is the best modality for cyst diagnosis as cysts cannot be differentiated from solid masses by mammography. In patients under 30 years old with a palpable breast mass, US should be utilized first. In older patients, mammography is obtained first, with ultrasound as indicated. For ultrasound, a high frequency transducer of 10 MHz or greater should be used first. If the lesion is deep, a lower frequency transducer may be utilized.
- Berg WA, Blume JD, Cormack JB, Mendelson EB. Operator dependence of physician-performed whole-breast US: lesion detection and characterization. Radiology. 2006 Nov;241(2):355-65. PMID: 17057064
- Berg WA, Campassi CI, Ioffe OB. Cystic lesions of the breast: sonographic-pathologic correlation. Radiology. 2003 Apr;227(1):183-91. PMID: 12668745
- Hilton SV, Leopold GR, Olson LK, Willson SA. Real-time breast sonography: application in 300 consecutive patients. AJR Am J Roentgenol. 1986 Sep;147(3):479-86. PMID: 3526839