A firm, round lump in breast tissue could be a fluid-filled cyst. Typically not cancerous, breast cysts often need no treatment.
Breast cysts are fluid-filled sacs inside the breast. They are usually noncancerous (benign). You may have one or multiple breast cysts. A breast cyst often feels like a grape or a water-filled balloon, but sometimes a breast cyst feels firm.
Breast cysts don't require treatment unless a cyst is large and painful or uncomfortable. In that case, draining the fluid from a breast cyst can ease symptoms.
Although breast cysts can be found in women of any age, they're more common in women before menopause, typically under age 50. But they can be found in women of any age. Breast cysts also commonly occur in postmenopausal women who take hormone therapy.
A breast cyst, an oval or round fluid-filled sac, may move slightly when you press on it.
Breast cysts may be found in one or both breasts. Signs and symptoms of a breast cyst include:
Having breast cysts doesn't increase your risk of breast cancer. But having cysts may make it harder to find new breast lumps or other changes that might need evaluation by your doctor. Your breasts may feel lumpy and painful when you're menstruating, so it's important to be familiar with how your breasts feel throughout your menstrual cycle so that you'll know if something changes.
Normal breast tissue often feels lumpy or nodular. But if you feel a new breast lump that doesn't go away, gets bigger or persists after one or two menstrual cycles, see your doctor right away. Also see your doctor if you have new skin changes on one or both of your breasts.
Each of your breasts contains lobes of glandular tissue, arranged like petals of a daisy. The lobes are divided into smaller lobules that produce milk during pregnancy and breast-feeding. The supporting tissue that gives the breast its shape is made up of fatty tissue and fibrous connective tissue. Breast cysts develop as a result of fluid accumulation inside the glands in the breasts.
Breast cysts may be defined by their size:
Experts don't know exactly what causes breast cysts. They may develop as a result of hormonal changes from monthly menstruation.
Diagnosis of a breast cyst usually includes a breast exam; imaging tests, such as a breast ultrasound or mammogram; and possibly fine-needle aspiration or a breast biopsy.
After discussing your symptoms and health history, your doctor will physically examine the breast lump and check for any other breast abnormalities. Because your doctor can't tell from a clinical breast exam alone whether a breast lump is a cyst, you'll need another test. This is usually either an imaging test or fine-needle aspiration.
Needed tests may include:
Your doctor may recommend a biopsy to further evaluate a mass that appears solid. If your doctor can easily feel a breast lump, he or she may skip imaging tests and perform fine-needle aspiration to drain the fluid and collapse the cyst.
During a fine-needle aspiration, your doctor inserts a thin needle into the breast lump and attempts to withdraw (aspirate) fluid. Often, fine-needle aspiration is done using ultrasound to guide accurate placement of the needle. If fluid comes out and the breast lump goes away, your doctor can make a breast cyst diagnosis immediately.
During fine-needle aspiration, a special needle is inserted into a breast lump, and any fluid is removed (aspirated). Ultrasound — a procedure that uses sound waves to create images of your breast on a monitor — might be used to help place the needle.
No treatment is necessary for simple breast cysts — those that are fluid filled and don't cause any symptoms — that are confirmed on breast ultrasound or after a fine-needle aspiration. Many cysts will disappear with no treatment. If a cyst persists, feels firmer or you notice skin changes on the skin over the cyst, follow up with your doctor.
Fine-needle aspiration may be used to diagnose and treat a breast cyst if all the fluid can be removed from the cyst during the procedure, and then your breast lump disappears and your symptoms resolve.
For some breast cysts, however, you may need to have fluid drained more than once. Recurrent or new cysts are common. If a breast cyst persists through two to three menstrual cycles and grows larger, see your doctor for further evaluation.
Using birth control pills (oral contraceptives) to regulate your menstrual cycles may help reduce the recurrence of breast cysts. But because of possible significant side effects, birth control pills or other hormone therapy, such as tamoxifen, is usually recommended only for women with severe symptoms. Discontinuing hormone therapy after menopause may also help prevent breast cysts.
Surgery to remove a breast cyst is necessary only in unusual circumstances. Surgery may be considered if an uncomfortable breast cyst recurs month after month or if a breast cyst contains blood-tinged fluid or shows other worrisome signs.
To minimize discomfort associated with breast cysts, you might try these measures:
Talk with your doctor about any vitamins, herbal remedies or other dietary supplements that you're taking or thinking of taking. There is no evidence that any of these products help breast cyst symptoms, and they may cause side effects.
You'll likely see your primary care provider to evaluate new breast lumps or changes in your breasts. You may be referred to a breast-health specialist based on a clinical breast exam or findings on an imaging test.
The first evaluation focuses on your medical history. You'll discuss your symptoms, their relation to your menstrual cycle and any other relevant information. To prepare for this discussion, make lists that include:
Basic questions to ask your doctor include:
Don't hesitate to ask questions anytime you don't understand something.
Be prepared to answer questions that your doctor may ask, such as: