A 50-year-old lady presented with lump in the left breast which has developed suddenly in weeks. Perimenstrual symptoms are present. No associated family history. On examination, the lump is well circumscribed, fluctuant, 1.5 cm oval in shape. Most likely diagnosis:
Ans: (a) Breast cystRef: Bailey and Love's Short Practice of Surgery, 26th editionBreast CystOccur most commonly in the last decade of reproductive lifeResults from a non-integrated involution of stroma and epithelium.Cavities lined by epitheliumCommon after the age of 35 years up to menopause. Uncommon after menopauseHormone replacement can cause cyst formation in old womenCyst size varies with menstruation due to influence of ovarian hormonesClinical FeaturesOften multiple, may be bilateral and can mimic malignancy.Typically present suddenly and cause great alarm; prompt diagnosis and drainage provides immediate relief.Multiple cysts seen is 50%. Often bilateral.Risk of breast cancer in breast cyst is very less (0.1%)Clinically--smooth, soft, fluctuant often transilluminating well-localised swelling DiagnosisDiagnosis can be confirmed by aspiration and/or ultrasound.On USG - Smooth margins and echofree centerTreatmentAspiration for Solitary cyst: If they resolve completely, and if the fluid is not blood-stained, no further treatment is required30% will recur and require reaspirationCore biopsy or local excision; If there is a residual lump or if the fluid is blood-stained, for histological diagnosis (exclude cystadenocarcinoma, which is more common in elderly women)Note:Fibroadenoma - usually between the ages of 15 and 25 yearsGalactocele - generally occurs after the cessation of location or when feeding frequency has curtailed significantly
Breast cyst
Galactocele
Fibroadenoma
Breast cancer
Breast