Simple Breast Cysts Research Articles

Genç Bir Erkekte Semptomatik Benign Meme Kisti

Simple breast cysts are benign lesions diagnosed in premenopausal women commonly presenting with a palpable breast lump. They are however, extremely rare in males due to the absence of lobular tissue in the male breast. We report a case of a benign breast cyst in a 19-year-old male who presented with a left breast lump and nipple discharge. Clinical examination revealed a non-tender 2x2 cm mobile retro-areolar lump in the left breast with clear serous nipple discharge upon milking of the duct. Ultrasonography showed typical features suggestive of a simple breast cyst and fine needle aspiration cytology revealed epithelial cells of apocrine origin, thus confirming the diagnosis. We review the literature and discuss the approach to investigation of these uncommon lesions presented in males.

Simple breast cyst with an atypical outcome

Introduction: Squamous cell carcinoma is a malignant neoplasm of epidermal keratinocytes, which rarely affects the breast, representing 0.1% to 2% of all types of breast cancer, and belonging to the heterogeneous group of metaplastic breast carcinomas. Clinically, it is associated with large tumors, tending toward cystic degeneration, with skin invasion and ulceration, and no specific radiological characteristics. It is also associated with a proliferative nature (Ki67) and triple-negative tumors. The prognosis is bleak, with a mean 5-year survival of 50% to 63%. Case report: A female patient, 37 years old, receiving palliative chemotherapy for stage IV endocervical adenocarcinoma (pT3 pN1 M1 – pleura) complained of a tumor in her left breast, with growth in the prior month. Physical examination revealed a palpable, mobile tumor in the central region of the left breast, measuring 11x9.5 cm, and with soft consistency. Mammography identified a regular, well-defined nodule in the left breast (BI-RADS 0). Breast ultrasound (BUS) indicated a simple cyst, with thin and regular walls, without a solid parietal component, measuring 7.6x5.2x4.3 cm. She underwent a BUS-guided relief biopsy of the cystic lesion with total removal of the lesion. Twenty days later, local recurrence occurred, and the lesion was drained again. Culture and cytology were negative for malignancy. She continued receiving chemotherapy. Eight months after the onset of symptoms, at the end of chemotherapy, and with no palpable lesion in the left breast, BUS revealed a simple 2.6 cm cyst, with no sign of flow on the Doppler study, and the patient was submitted to excision of cystic lesion guided by radioguided occult lesion localization (ROLL). Anatomopathological results indicated triple-negative metaplastic carcinoma, measuring 2.7 cm, with squamous differentiation and free surgical margins. Sentinel lymph node biopsy in the left axilla showed two lymph nodes free of neoplastic involvement. Adjuvant treatment consisted of FAC chemotherapy and hypofractionated radiotherapy. Currently, at 18 months of follow-up, she has no evidence of recurrence. Conclusion: Simple breast cysts are benign lesions, with active surveillance, except in the case of recurrence, residual mass after relief biopsy, or presence of bloody fluid in the biopsy material. This report describes a rare case of metaplastic carcinoma, which must be remembered as a differential diagnosis in recurrent breast cyst.

Simple breast cysts: should we treat or not?

Simple breast cysts: should we treat or not?

Effectiveness of single-session ultrasound-guided percutaneous ethanol sclerotherapy in simple breast cysts.

We aimed to evaluate the effectiveness of single-session ultrasound-guided percutaneous ethanol sclerotherapy in simple breast cysts. From January 2002 to January 2014, 35 simple breast cysts (mean volume, 8.2 mL; range, 4-33 mL) in 28 females (mean age, 39 years) were evaluated. In a single session, all cysts were aspirated using 20G needles, refilled with 99% ethanol (90% of the volume of the aspirated fluid), and reaspirated completely after 10 minutes of exposure under ultrasound guidance. Follow-up ultrasonography examinations were performed at one week, one month, three months, and six months for all patients and 12 months, 18 months, and 24 months for available patients. Follow- up duration varied between 6 and 24 months (mean, 15 months). The technical success rate of ultrasound-guided percutaneous etha-nol sclerotherapy was 97%. The needle tip was dislocated and ethanol was given into the breast parenchyma in one patient (3%). One cyst (3%) was reaspirated at the first week follow-up due to intracystic hemorrhage. Of the 34 cysts treated, 25 (74%) completely responded to therapy and were no longer detectable on follow-up examinations. Eight cysts (24%) significantly decreased in size and then completely disappeared at six months. At the end of the follow-up period, the clinical success rate reached 100%, and none of the cysts were visible. Except mild to moderate sensation of burning or pain which disappeared or subsided significantly in a couple of minutes, no other complications were observed in patients. Ultrasound-guided ethanol sclerotherapy is a fast, safe, and highly effective method in the treatment of simple breast cysts.

Benign Breast Cyst without Associated Gynecomastia in a Male Patient: A Case Report

Benign simple breast cysts are commonly seen in female breasts and can present as palpable masses. They are distinctly uncommon, however, in the male breast. We report a case of simple benign cyst of the breast in a 58-year-old man newly diagnosed with mantel cell lymphoma. The cyst was first identified incidentally on a staging contrast-enhanced chest computed tomography. Further evaluation with mammography and ultrasound revealed a mass that would be typically characterized as a benign simple cyst, but was biopsied since cysts are not known to occur in male breasts. Pathology results from ultrasound-guided core needle biopsy revealed benign cyst and focal fibrosis which was concordant with the imaging findings. In this case report, we will briefly discuss breast cysts in men and their imaging features including mammography and ultrasound.

The predictive value of suspicious sonographic characteristics in atypical cyst-like breast lesions

Background and purpose Simple breast cysts are a common sonographic finding and do not require further diagnostic evaluation. In contrast, atypical breast cysts do harbour a risk of malignancy. The purpose of this study was to evaluate the predictive value of sonographic findings that are considered characteristic of malignant atypical cyst-like lesions. Patients and methods Six descriptive sonographic criteria of 202 atypical cysts in 176 women were compared with histopathological findings after surgical excision and their statistical association was evaluated. Results Of these six criteria thick cyst wall ( p < 0.0001), lobulation ( p = 0.0001) and hyperechogenicity ( p = 0.003) were found to be highly predictive of breast cancer. The presence of two or more sonographic criteria was associated with a 10.3 times greater risk of malignancy ( p < 0.0001). Conclusion The association between suspicious sonographic criteria and histology after surgery was evaluated. We propose surgical excision when two or more sonographic criteria are diagnosed in a single atypical breast cyst.

The validity of complex breast cysts after surgery

Background Breast cysts are the most common cause of benign breast masses. Simple breast cysts do not need further evaluation, but complex breast cysts require additional assessment due to the potential presence of malignancy. However, these complex cysts have rarely been examined and quantified according to the associated cancer detection rate. Our study is the first investigation to evaluate the malignancy rate of complex breast cysts identified by histopathological results. Methods Imaging findings of complex cysts were correlated retrospectively with clinical and pathologic outcomes. We detected a malignancy rate of 14%. Sonographic criteria of a complex cyst such as thick cyst wall ( P = .0006), lobulation ( P = .01), and hyperechogenicity ( P = .04) were predictive of neoplasm. Two or more criteria combined were associated with a 13.6-fold higher risk of malignancy ( P <.0001). Conclusion Based on our results we reinforce the importance of adequate assessment of complex breast cysts to prevent a missed or delayed diagnosis of malignancy.

Sonographic detection of intracystic breast tumors

While simple breast cysts account for the most common benign lesions of the breast, intracystic tumours, which most frequently occur as papillomas and papillary adenocarcinomas, are rare. In this paper we report on the clinical picture of these tumours, using our own material, and discuss the relevance of sonography in pre-operative diagnosis compared to conventional examination techniques such as mammography and pneumocystography.

The validity of complex breast cysts after surgery

1519 Objective: Breast cysts are the most common cause of benign breast masses. Simple breast cysts do not need further evaluation, but complex breast cysts require additional assessment due to the potential presence of malignancy. However these complex cysts have rarely been examined and quantified according the associated cancer detection rate. Our study is the first investigation that evaluates the malignancy rate of complex breast cysts identified by histo-pathological results. Material and Methods: Imaging findings of complex cysts were correlated retrospectively with clinical and pathologic outcomes. Results: 150 complex breast cysts were found in 132 women. We detected a high malignancy rate of 14%. Sonographic criteria of a complex cyst such as thick cyst wall (p=0.0006), lobulation (p=0.01) or hyperechogenicity (p=0.04) were predictive of neoplasm. Two or more criteria combined were associated with a 13.6 - fold higher risk of malignancy (p&lt;0.0001). Menopause status, family history or personal history of breast cancer did not influence the detection rate of neoplasm. Conclusion: Based on our results we raise the issue for the need of surgical intervention, compared to observation by ultrasound of complex breast cysts to prevent a missed or delayed diagnosis of breast cancer. No significant financial relationships to disclose.

A finite element model for simulating acoustic streaming in cystic breast lesions with experimental validation

Streaming detection is an ultrasonic technique that can be used to distinguish fluid-filled lesions, or cysts, from solid lesions. With this technique, high intensity ultrasound pulses are used to induce acoustic streaming in cyst fluid, and this motion is detected using Doppler flow estimation methods. Results from a pilot clinical study were recently published in which acoustic streaming was successfully induced and detected in 14 of 15 simple breast cysts and four of 14 sonographically indeterminate breast lesions in vivo. In the study, the detected velocities were found to vary considerably among cysts and for different pulsing regimes. A finite element model of streaming detection is presented. This model is utilized to investigate methods of increasing induced acoustic streaming velocity while minimizing patient exposure to high intensity ultrasound during streaming detection. Parameters studied include intensity, frequency, acoustic beam shape, cyst-diameter, cyst fluid protein concentration, and cyst fluid viscosity. The model, which provides both transient and steady-state solutions, is shown to predict trends in streaming velocity accurately. Experimental results from studies investigating the potential for nonlinear streaming enhancement in cysts are also provided.

CT attenuation of fluid in breast cysts.

The authors' purpose was to determine whether computed tomographic (CT) attenuation values of fluid in breast cysts could be in the range of values for soft tissue and could be correlated with protein content of the fluid. Aspirate samples from 10 simple breast cysts were analyzed for protein content, and CT attenuation values were calculated by means of a breast phantom. A corrected attenuation value for breast-cyst fluid was calculated by using sterile water as a control. The mean corrected attenuation value for the cyst aspirate was 28.1 HU; most simple cysts have an attenuation value of only 10 HU. Protein concentration ranged from 0.9 to 2.4 g/dL. A significant, almost linear relationship was noted between protein content and attenuation value of cyst fluid (r = .85, P < .01). The CT attenuation values of breast cysts can be in the range of those of soft tissue. This high attenuation value is correlated with the high protein content of breast-cyst fluid. Therefore, an apparent circumscribed soft-tissue mass seen within the breast at CT may represent a simple cyst.

Disappearing breast cysts

The natural history of simple breast cysts is illustrated by our patient with multiple palpable cysts which disappeared completely over a six month period. Interval mammography is all that is required in these patients.

The use of duplex Doppler ultrasound in the diagnosis of breast cancer

Duplex Doppler ultrasound was used to examine 50 breast lesions in 45 patients. Examination was confined to the region of interest, which in most cases was a palpable lump, and the corresponding area of the contralateral breast as a control. In only one patient was a Doppler signal obtained from a normal breast. Nine of the 50 lesions were believed to represent simple breast cysts at sonography and were not treated further. The remaining 41 lesions were excised; 22 were carcinomas and 19 benign (fibrocystic disease 7, fibroadenomas 5, miscellaneous 7). Doppler signals were obtained in 20 of the carcinomas and three of the benign lesions. In this series, the sensitivity of duplex Doppler ultrasound for the detection of breast carcinoma was 91%, and the specificity 89%. The positive predictive value was 87% and the negative predictive value 93%.

Cystic thyroid nodules. The dilemma of malignant lesions

In contrast to opinions expressed even less than 10 years ago, present sentiment and publications endorse the general technique of fine-needle aspiration (FNA) for the diagnosis of thyroid nodules. 1,2 Following verification that both aspirationist and cytopathologist have achieved a high degree of accuracy and reliability, the results of FNA usually form the principal basis on which thyroid nodules are managed. Recent publications have focused on identifying and further refining the inadequacies of FNA. 3,4 De los Santos et al5 have correctly pointed out a potential problem with the technique, that of establishing a firm diagnosis on thyroid nodules that are at least partially cystic. In contradistinction to nonbloody simple breast cysts that are virtually always benign, the possibility of a partially cystic thyroid malignancy is clearly a real concern. See also p 1422. This retrospective study of 221 surgically resected thyroid nodules demonstrated that nearly one third were cystic,

Cystic Thyroid Nodules

In contrast to opinions expressed even less than 10 years ago, present sentiment and publications endorse the general technique of fine-needle aspiration (FNA) for the diagnosis of thyroid nodules.^1,2Following verification that both aspirationist and cytopathologist have achieved a high degree of accuracy and reliability, the results of FNA usually form the principal basis on which thyroid nodules are managed. Recent publications have focused on identifying and further refining the inadequacies of FNA.^3,4De los Santos et al5 have correctly pointed out a potential problem with the technique, that of establishing a firm diagnosis on thyroid nodules that are at least partially cystic. In contradistinction to nonbloody simple breast cysts that are virtually always benign, the possibility of a partially cystic thyroid malignancy is clearly a real concern. See also p 1422. This retrospective study of 221 surgically resected thyroid nodules demonstrated that nearly one third were cystic,