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Tests and diagnosis
By Mayo Clinic staffScreening and diagnosis of a breast cyst usually begins after you or your doctor has identified a breast lump. The process may involve the following tests or exams:
- Clinical breast exam. Your doctor physically examines the breast lump and checks for any other problem areas in your breasts. Questions to anticipate include when you first noticed the lump, whether its size has changed, if you have any breast pain associated with the breast lump, whether you have nipple discharge and how your menstrual cycle affects the lump. However, your doctor can't tell from a clinical breast exam alone whether a breast lump is a cyst, so you'll need another test, either an imaging test or fine-needle aspiration.
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Breast ultrasound. Breast ultrasound can help your doctor determine whether a breast lump is fluid-filled or solid. The radiologist — a doctor trained to perform imaging exams and procedures — performing the ultrasound makes this determination based on certain characteristics seen during the imaging exam. A fluid-filled area usually indicates a breast cyst. A solid-appearing mass most likely is a noncancerous lesion, such as a fibroadenoma, but solid lesions could also be breast cancer. Based on what they see on the ultrasound, your doctor and radiologist might recommend a biopsy to further evaluate a solid-appearing mass.
If your doctor can easily feel a breast lump, he or she may skip breast ultrasound and perform fine-needle aspiration instead.
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Fine-needle aspiration. During this procedure, your doctor inserts a thin needle into the breast lump and attempts to withdraw (aspirate) fluid. If fluid comes out and the breast lump goes away, your doctor can make a breast cyst diagnosis immediately.
Unless there appears to be blood in the fluid, it requires no further testing or treatment after draining. If the fluid is bloody, a laboratory may need to test it. Lack of fluid or a breast lump that doesn't disappear after aspiration suggests that the breast lump — or at least a portion of it — is solid, and a sample of cells may be collected and sent for analysis to check for the presence of cancer (fine-needle aspiration biopsy).
- Non-cancerous breast conditions. American Cancer Society. http://www.cancer.org/docroot/CRI/content/CRI_2_6X_Non_Cancerous_Breast_Conditions_59.asp?sitearea. Accessed April 7, 2010.
- Lucas JH, et al. Breast cyst aspiration. American Family Physician. 2003;68:1983.
- Sabel MS. Overview of benign breast disease. http://www.uptodate.com/home/index.html. Accessed April 9, 2010.
- Courtillot C, et al. Benign breast diseases. Journal of Mammary Gland Biology and Neoplasia. 2005;10:325.
- Understanding breast changes: A health guide for women. National Cancer Institute. http://www.cancer.gov/cancertopics/understanding-breast-changes. Accessed April 9, 2010.
- Laronga C, et al. Breast cysts: Diagnosis and management. http://www.uptodate.com/home/index.html. Accessed April 9, 2010.
- Miltenberg DM, et al. Benign breast disease. Obstetrics and Gynecology Clinics of North America. 2008;35:285.
- Pruthi S, et al. Vitamin E and evening primrose oil for management of cyclical mastalgia: A randomized pilot study. Alternative Medicine Reviews. 2010;15:59.
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