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Jan 24, 2014 03:34PM Beesie wrote:
Morwenna, you're right, the percents were much higher. Thanks for catching that.
I wasn't trying to analyse your cyst but was just responding to the previous conversation about how rare it is to have a malignancy in a cyst. It is very rare for most cysts, but not for the type of cyst that you had. Since there is a significant solid component in these types of cysts, I'm surprised that they call them "cysts". They should use a different name so that there is a very clear distinction between simple and complicated cysts, which overall have a 0.3% malignancy rate (or even less), and highly complex cysts, which do present a significant cancer risk. If Mdee's cysts were aspirated and completely disappeared (even if they did reappear later, which can happen with a cyst; the fluid can refill the sac), then it's likely that her original cysts were simple or complicated cysts, not a high risk complex cyst. That was the distinction I was trying to make in my first post yesterday.
I agree that lumps should never be ignored - every lump should be screened and identified/diagnosed. But if someone has what is clearly visible on an ultrasound as being a simple cyst, or a complicated cyst (perhaps a little bit of debris or perhaps not perfectly round or oval), the risk is extremely low and the rating will be either a BIRADs 2 (no action necessary, generally given when imaging shows a simple cyst and/or multiple cysts) or a BIRADs 3 (six month follow-up, generally given when imaging shows a single complicated cyst). There is nothing wrong with that approach for these types of cysts, in fact it's entirely appropriate - presuming that the cyst is clearly identified by the ultrasound as being a simple or complicated cyst.
Alternately, if the imaging isn't completely clear in identifying a mass as a simple or complicated cyst, or if the cyst appears to have a significant solid component, then the rating given to the imaging will usually be a BIRADs 4, indicating that a biopsy is necessary. The first approach might be a fine needle aspiration; if that isn't successful at completely eliminating the cyst, or if the needle hits something solid, then usually a core needle biopsy will be required.
I have extremely dense breast tissue and some of my cysts could not be
clearly identified as being cysts, so those were always aspirated. But
I've also had cysts that were obviously cysts; if they were small (and
therefore not blocking the imaging), they've been left in place. I pretty much always have a cyst or two in my breast, and over the years I've had BIRADs 2, BIRADs 3 and BIRADs 4 imaging ratings all depending on the clarity of the image and the characteristics of the cyst.
All that to say that there are many different ways that a cyst might present, and the risk associated with the cyst and what should be done about it can vary hugely case by case. Overall, however, it's important to remember that a very high percentage of women will develop a cyst or two (or many more) during their lives, and most of those cysts are simple or complicated cysts and are completely benign and harmless.
Dx 9/15/05, DCIS-MI, 6cm+ Gr3 DCIS w/IDC microinvasion, Stage I, 0/3 nodes, ER+/PR- “No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke