A 37-year-old woman presents to AIIMS OPD with a lump in the left breast.Family history is negative for breast cancer. On Examination the mass is rubbery, mobile, and nontender to palpation. No overlying skin changes and the axilla is negative for lymphadenopathy Ultrasound repo suggest a simple 1-cm cyst in the area of the palpable mass in the left breast. Most appropriate management of this patient?
Reassurance and re-examination are recommended in this case A complex cyst is almost never associated with a malignancy. A complex cyst may be associated with an underlying malignancy and aspiration is usually recommended. -If cyst disappears with aspiration and the contents are not grossly bloody - Fluid does not need to be sent to cytologic analysis. -If the lesion does not completely disappear or recurs multiple times after aspiration - Fluid should be sent for cytology. Excision of a cyst is indicated if the cytologic findings are suspicious for malignancy. In young women, the breast parenchyma is dense, which limits the diagnostic value of mammography. A fluoroscopically guided needle localization biopsy is reserved for nonpalpable solid lesions of the breast. Breast cyst - Seen in last decade of reproductive life - Due to non-integrated involution of stroma and epithelium Clinical features - Multiple - Can be bilateral Can mimic malignancy- Sudden presentation can be used to differentiate from malignancy
Reassurance and re-examination
Fluoroscopically guided needle localization biopsy
Aspiration of the cyst with cytologic analysis
Immediate excisional biopsy,
Breast