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Topic: They said lump was a cyst but it has not gone away

Forum: Not Diagnosed but Worried —

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Posted on: Feb 13, 2018 09:35AM

Nlo91011 wrote:

Hi all,

I noticed a lump back in December and made an appointment right away with my gynecologist. She sent me for a mammogram. The mammogram showed a 1.8 cm nodule where the lump is and then another 1.2 cm nodule. They said my breasts are heterogeneously dense so they also did an ultrasound. They saw numerous cysts in both breasts. I was just about to get my period so I assumed all was fine and the lump would go away. As of today (2/13) the lump is still there and has remained all throughout the past month and a half. So I emailed my doctor to ask if by chance the cysts were hiding something and should I be concerned. Her reply was that she'd like me to see a breast surgeon. So now I have an appointment Friday. Has anyone had cysts hide something? I hate spending money for appts that are a waste! Thanks in advance.

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Feb 13, 2018 10:11AM Peregrinelady wrote:

As someone who was told that my palpable lump was benign by a incompetent PCP after a negative mammogram and ultrasound, I wish someone had sent me to a breast surgeon. Better safe than sorry.
Dx 4/24/2015, IDC, Left, 2cm, Stage IIB, Grade 2, 1/2 nodes, ER+/PR+, HER2- Hormonal Therapy 6/1/2015 Liquid tamoxifen (Soltamox) Surgery 4/18/2016 Mastectomy: Left, Right; Prophylactic ovary removal; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Hormonal Therapy Arimidex (anastrozole)
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Feb 13, 2018 10:19AM - edited Feb 13, 2018 10:25AM by Beesie

Most cysts eventually go away on their own, but not always quickly. I have one cyst that I've had for years; sometimes it's bigger, sometimes it's smaller, sometimes I notice it and it can be painful, other things I'm not aware that it's there.

Do you have a copy of your ultrasound report? If not, ask your doctor for a copy. How are the cysts described? If they are 'simple cysts' then they are entirely fluid filled and completely harmless. If they are 'complicated cysts' or 'cysts with debris', then they are almost certain to be harmless but should be monitored with a follow-up ultrasound in 6 months. The report should include a BIRADs rating. A BIRADs 2 would indicate that although something was seen on the imaging (i.e. the cysts), what was seen was deemed to not be of any concern. BIRADs 2 ratings are usually given for simple cysts. A BIRADs 3 rating would indicate that although what was seen on the imaging is highly unlikely to be cancer, short term follow-up is recommended. BIRADs 3 ratings are usually given for complicated cysts.

If your report clearly indicates that you have simple cysts, with a BIRADS 2 rating, there really is no reason to see a breast surgeon. The fact that your cysts are still there after just one month is not a concern, it's normal and not unusual at all.

By the way, I've had literally dozens of cysts of my life. Even though I have a history of breast cancer, I trust the Radiologist's assessment when her report says that my cysts are nothing to be concerned about. The fact is the simple and complicated cysts are usually very easy to accurately identify with ultrasound imaging the fluid inside is clearly visible.

Dx 9/15/05, DCIS-MI, 6cm+ Gr3 DCIS w/IDC microinvasion, Stage IA, 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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Feb 13, 2018 10:27AM Nlo91011 wrote:

Hi Beesie,

That's what I was wondering, if I should wait it out. This is my report :

Left Breast ultrasound. Examination performed under direct Radiologist supervision. BREAST COMPOSITION: C: The breast is heterogeneously dense, which may obscure small masses. FINDINGS: Right Breast: There are rounded contours in the upper/outer quadrant, largest measuring approximately 3.4 CM. Otherwise unremarkable. Right breast ultrasound: Ultrasound targeted to the upper/outer quadrant demonstrates several cysts. At 9:00, 3 CM from the nipple is a simple cyst measuring 2.6 x 2.8 x 1.5 CM. At 9:00 4 CM from the nipple is a simple cyst measuring 1.4 x 1.4 x 0.9 CM. At 10:00 4 CM from the nipple is a simple cyst measuring 1.3 x 0.8 x 1.5 CM. Left Breast: A BB has been placed over the palpable abnormality in the upper/outer breast. Deep to this is an approximately 1.8 CM rounded nodule. There is at least one additional rounded nodule measuring 1.2 CM, in the upper/outer quadrant. Otherwise unremarkable. Left breast ultrasound: Ultrasound targeted to the upper/outer quadrant. At 12:00 1 CM from the nipple is a simple cyst measuring 0.7 x 0.7 x 0.6 CM. At 2:00 5 CM from the nipple is a simple cyst measuring 0.6 x 0.5 x 0.5 CM. At 3:00 3 CM from the nipple, and corresponding to the palpable abnormality, is a simple cyst measuring 1.3 x 1.2 x 1.2 CM. IMPRESSION: -There is no radiographic evidence of malignancy. -The palpable abnormality on the left corresponds to a simple cyst measuring 1.3 x 1.2 x 1.2 CM. -There are simple appearing cysts bilaterally in the upper/outer quadrants. -Routine annual mammography suggested. Birads Category 2-Benign Finding Result code B2 Follow-up code L1D3 Patient's information was entered into a reminder system with a target date for next examination. 
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Feb 13, 2018 10:29AM Nlo91011 wrote:

I'm sorry that happened to you. That's my fear. When she did that ultrasound she only did the top half my breasts, not my whole breast. The lump is deep so I'm wondering if she did the lower part of my breast if something would have been seen.

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Feb 13, 2018 10:53AM Beesie wrote:

Nlo,

From your report, it's clear that the lump that you can feel has been clearly identified as a simple cyst. That's great and together with the BIRADs 2 rating, it means that no follow-up is necessary.

It would be very different if you felt a distinct lump and your imaging didn't show anything or couldn't identify what the lump was (which unfortunately appears to be what happened in Peregrinelady's case). Your lump has been identified. It is a simple cyst. It appears that you have lots of simple cysts - some of us just do.

Here is some information about cysts:

Breast Cysts

Breast Cysts

Breast Cysts - Breast Ultrasound Images

If the cyst is painful or large enough to bother you, then you might want to see the Breast Surgeon to have it aspirated. I've had some very large cysts that I have had aspirated, but once clearly identified on an ultrasound, I've always left the small ones to eventually (sometimes it would take years) dissipate on their own.

Dx 9/15/05, DCIS-MI, 6cm+ Gr3 DCIS w/IDC microinvasion, Stage IA, 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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Feb 13, 2018 10:57AM - edited Feb 13, 2018 11:07AM by djmammo

Nlo91011

Unlike on mammography, cysts and other masses don't actually "hide" or obscure other things seen on ultrasound however, if one presents to sonography with the complaint of a lump, the area of interest is scanned, and the remainder of the breast is not routinely scanned if the mammogram is otherwise negative.

Also it may not seem like the tech is looking at a wide enough area while scanning but, depending on the size of the breast, one can sweep through a good portion of it merely by tilting the transducer to one side then the other. The US beam is fan shaped and by tilting and pivoting you can see quite a bit without sliding the transducer around on the skin.

We rads live in fear of missing a cancer by assuming one is feeling the same thing previously imaged, without proof.

Board Certified Diagnostic Radiologist specializing in Breast Imaging helping members understand their health care provider's reports and recommendations.
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Feb 13, 2018 10:58AM Nlo91011 wrote:

Thanks Bessie. I just wasn't sure I cyst can hide something if it's on top of a nodule. That's why I emailed my doctor to ask. I have friends and family who have had cysts but said their lumps always go away after their period and mine hasn't. I think I'll cancel my appointment and just wait it out.

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Feb 13, 2018 11:05AM Nlo91011 wrote:

Thanks all, I appreciate the input. I'm going to cancel my appointment.

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