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All TopicsForum: Not Diagnosed but Worried → Topic: Has anyone w/ cysts aspirated had a scare?

Topic: Has anyone w/ cysts aspirated had a scare?

Forum: Not Diagnosed but Worried — Meet others worried about developing breast cancer for the first time.

Posted on: Jan 23, 2014 05:03PM

Mdee wrote:

I've written once about this.

My history: 43 yrs old

I've had 2 large, painful cysts grow in the exact same spot on my right breast since 2007. Last was 2012.

The breast surgeon who did the first drain said I had a large tissue from where the cyst was growing from. My right breast is larger than the left. My breasts are large, wear a 40c at the moment (25 lbs overweight)

I remember asking him if I should get it removed, he remarked it was surgery and didn't act too concerned with it.

The cyst grew back in the same spot 5 yrs later. All tests performed and it was drained again. I know what that area feels like, so I've never been concerned.

You can feel this tissue move around. I have no puckering, my right breast looks as it always have.

 In fact, my GP did a breast exam less than two weeks ago and didn't say anything.

Now I'm in a new state and had my mammogram. That area where my cysts grew lit up and had to have a diagnostic mammo and ultrasound. When the ultrasound tech was rolling around that area, it would hurt exactly like it did when I had a cyst there, like rolling over a nerve.

The radiologist said it was "worrisome". She said it "could" be scar tissue from my past procedures but didn't know until biopsy.

I was never told in all the tests I've had done because of these cysts that this area would ever be of concern.

I haven't been able to find anyone who has had a history of large cysts like mine to then have to have a biopsy in that same area.

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Posts 1 - 17 (17 total)

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Jan 23, 2014 05:17PM TotallyBlessed wrote:

Hi Mdee,

I'm sure the Doctor is being super proactive.  I had a cyst aspirated about 18 years ago. Had always had problems with them. Recently had an ultrasound guided core biopsy on the exact area which turned out b9.  Praying for the same results for you :)

Let Go, Let God

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Jan 23, 2014 07:10PM Mdee wrote:

Thanks TotallyBlessed. 

My biopsy is in the morning.

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Jan 23, 2014 08:32PM Srh242 wrote:

Yes, they told me was a cyst while pregnant. One year after I demanded a biopsy and when they went in they couldnt take any fluid out cause it was cancer.

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Jan 23, 2014 08:59PM Mdee wrote:

Thanks Srh242:

My two cysts were drained They grew from large tissue there (that's what the breast surgeon who did the 1st aspiration)

 Now, this spot is considered "worrisome" to the radiologist and she wants to do a biopsy. That area feels the same as it always has.

Sometimes during my period, I will feel that same twinge there like the cyst is going to grow back.

All my previous tests were done in Texas where I lived, now I'm in Phoenix. I guess the radiologist is being over cautious since I' new to them.

 I heard it's better to keep having your tests done at the same place.

I'm scared to death.

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Jan 23, 2014 09:33PM Srh242 wrote:

Hi Mdee: with your history is probably another cyst. But is good that you are been proactive. Maybe asking for an mri once a year can help see the big picture. Good luck

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Jan 23, 2014 10:37PM Morwenna wrote:

I had large cysts aspirated twice in my late 30's/early 40's. There was never any suggestion of malignancy, even though I was worried with the first one. The lump I felt in September 2012 felt just the same to me..

I remember a colleague at work way back then reassuring me. She told me she had had cysts for years ...... I remember hearing some years later that she had gone on to have a mastectomy. 

In fact my new lump was partially cystic, but turned out to be cancerous ......

I guess it shows that you just always have to get these things checked out and not get complacent.

Dx 11/8/2012, IDC, 6cm+, Stage IIIa, Grade 3, 1/11 nodes, ER-/PR-, HER2-Surgery 11/23/2012 Lumpectomy (Left); Lymph Node Removal: Sentinel Lymph Node Dissection, Axillary Lymph Node Dissection (Left)Surgery 12/12/2012 Mastectomy (Left)Chemotherapy 01/09/2013 Adriamycin, Cytoxan, TaxolRadiation Therapy 07/22/2013 External
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Jan 23, 2014 10:52PM, edited Jan 23, 2014 10:56PM by Mdee

If the biopsy was on any other area of my breast, I would be freaking out more. But the fact that it's the same piece of tissue where I've grown 2 cysts is somewhat of a relief, if that makes sense.

Even though that doesn't mean things can't change for the worse.

I'm hoping it's just scar tissue or something tied with the problems with the cysts I've had.

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Jan 23, 2014 10:56PM MelissaDallas wrote:

Approximately 60% of women have fibrocystic breasts so it would compute that 60% of women who get cancer also had cysts but simple cysts are always benign and never turn cancerous so one didn't cause the other. Fewer than 1% of complex or complicated cysts turn out to be cancerous.

LCIS, extensive sclerosing adenosis, TAH/BSO & partial omentectomy for mucinous borderline ovarian tumor.

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Jan 23, 2014 10:58PM Morwenna wrote:

Fewer than 1% ..... Yes, that would be me! ;p

Dx 11/8/2012, IDC, 6cm+, Stage IIIa, Grade 3, 1/11 nodes, ER-/PR-, HER2-Surgery 11/23/2012 Lumpectomy (Left); Lymph Node Removal: Sentinel Lymph Node Dissection, Axillary Lymph Node Dissection (Left)Surgery 12/12/2012 Mastectomy (Left)Chemotherapy 01/09/2013 Adriamycin, Cytoxan, TaxolRadiation Therapy 07/22/2013 External
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Jan 23, 2014 11:04PM MelissaDallas wrote:

Morwenna, I've been "lucky" enough to get the weird stuff tooLoopy Heck, I'd never even heard of either mucinous cancer or LCIS.

LCIS, extensive sclerosing adenosis, TAH/BSO & partial omentectomy for mucinous borderline ovarian tumor.

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Jan 23, 2014 11:17PM Beesie wrote:

Benign cysts are very common.  Having benign cysts does not increase your risk to develop breast cancer.  Benign cysts do not become cancer.  If a cyst was aspirated and found to be benign, it won't develop into cancer.

The fact that someone had cysts and then developed breast cancer does not mean that the two conditions are in any way connected.  I have had fibrocystic breasts since I was a teenager and I've had lots of cysts (and still have some). I developed breast cancer.  It had nothing to do with the fact that I had cysts.

I've had more cysts than I can remember - I'm sure at some point I've had a cyst pretty much everywhere in my breast.  I've had several biopsies, so I have had biopsies in areas that once had cysts.  They were not connected.  And I developed breast cancer in an area of my breast that previously had cysts.  Not connected.

The rate of malignancy with cysts is something like 0.3%.  Cysts that are malignant are almost all extreme complex cysts, cysts that either include some fluid but also have a large solid component (i.e. a partially cystic mass), or cysts that have very thick and uneven walls.  Those types of cysts look different on an ultrasound as compared to most cysts, and usually are immediately biopsied.  Standard cysts - either simple cysts or complicated cysts (cysts that might include a bit of debris or perhaps aren't perfectly round or oval) are almost always benign and harmless. 

Having benign cysts does not mean that you can't also develop breast cancer. You can have another problem with the breast tissue in your breast, even possibly in the same area of your breast.  But it's not the cyst that is causing the cancer.  Something that is a solid mass could be misdiagnosed as a cyst if the imaging isn't clear.  Ultrasounds usually are best at showing the fluid inside the cyst but if an ultrasound can't clearly distinguish between a cyst and a solid mass, then normally an aspiration will be done to confirm that the mass is a cyst.  Another possible problem is that a cyst, if large and not aspirated, can block breast tissue on imaging and reduce the effectiveness of your screenings.  That's why large cysts are usually aspirated.  Small cysts (if they are clearly cysts) don't need to be.

Here is some good factual information about cysts:

Sonographic Differentiation of Benign and Malignant Cystic Lesions of the Breast     

The Sonographic Findings and Differing Clinical Implications of Simple, Complicated, and Complex Breast Cysts

Lots of women come to this board with run-of-the-mill cysts.  It's important that we present accurate and factual information and not cause unnecessary fear.

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

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Jan 23, 2014 11:27PM Beesie wrote:

Morwenna, take a look at the first link in my previous post.  If you had a partially cystic mass, that would fit the definition of a Type VI cyst, according to the definitions in at article.  Those types of cysts had a 33% malignancy rate in their study.  That compares to a 0% malignancy rate for Types I, II, III and IV cysts, and a 7% malignancy rate for Type V cysts.  

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

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Jan 23, 2014 11:46PM, edited Jan 24, 2014 12:00AM by Morwenna

Yes, thanks Beesie, but I was not actually looking for an analysis of my own cyst. I never meant to infer that my cysts had "turned cancerous", and I don't think I said that.

I was merely a) answering the original question, and b) making the point that lumps should not be ignored, as I nearly did with mine, just because previous cysts were benign. 

Edit: Actually, if you have another look at the link you posted, those figures (7 and 33) were the actual number of malignancies, not the percentage rate, which was considerably higher!

Dx 11/8/2012, IDC, 6cm+, Stage IIIa, Grade 3, 1/11 nodes, ER-/PR-, HER2-Surgery 11/23/2012 Lumpectomy (Left); Lymph Node Removal: Sentinel Lymph Node Dissection, Axillary Lymph Node Dissection (Left)Surgery 12/12/2012 Mastectomy (Left)Chemotherapy 01/09/2013 Adriamycin, Cytoxan, TaxolRadiation Therapy 07/22/2013 External
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Jan 23, 2014 11:51PM Srh242 wrote:

Hi Beesie: my cyst were never aspirated, what size is considered a large cyst?

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Jan 24, 2014 12:23AM Mdee wrote:

My cysts were so big they pushed out on the side of my breast!

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Jan 24, 2014 02:16AM Mdee wrote:

I think another thing that makes me wonder is that my regular doctor did a breast exam a week before my mammo and didn't say a word about it.

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Jan 24, 2014 10:34AM 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