Breast Cysts

Breast cysts, calcifications, and fibrocystic breast changes are all breast conditions that share one important characteristic – they are usually benign (not-cancerous). Knowing the differences among these conditions and what causes them can help you decide when to see a doctor.

Breast Cysts

Breast cysts are fluid-filled sacs that are found in breast tissue. They differ from most breast lumps in that they aren’t solid. They can vary in size, and they are usually not cancerous. Women with breast cysts may have only one or a few cysts, and others may have many. Breast cysts may occur in only one breast or in both breasts. Cysts are usually round or oval, and they tend to have smooth and obvious edges – like a pea or a grape. While most cysts feel pliable, some are firm.

Most happen in women ages 35 to 50, but they can occur in women of any age.

Breast cysts aren’t always painful, but they can cause pain and discomfort. If a breast cyst isn’t causing any pain, you probably won’t need treatment. But if you are uncomfortable, your doctor may drain fluid from your cysts (or cysts) to help ease the symptoms.

The good news is that having them doesn’t increase your chances of developing breast cancer. However, having cysts in your breast can make it harder for you to detect breast cancer if it does develop. It’s vital for you to follow your doctor’s recommendations regarding your annual exams and mammograms and to perform monthly breast self-exams to get to know your breasts so you’ll be aware if any changes occur.

Signs and Symptoms

The signs and symptoms of breast cysts vary from person to person, but they may include:

• a lump in the breast tissue that is usually round or oval and has distinct, smooth edges
• nipple discharge that can be clear, yellow, gold, or brown
• breast pain or tenderness around the cyst(s)
• increase in the size of the cyst(s) just before the beginning of your period and a decrease in size (and any related discomfort) after your period

Simple Cyst versus Complex Cyst

There are two general types of breast cysts – simple and complex.

• Simple cysts are cysts that contain only clear fluid. These are almost always benign (non-cancerous), and they make up about 95 percent of all cysts seen on a screening mammogram.
• Complex cysts contain debris, like blood or other matter, and they should most often be evaluated by a breast biopsy.

Causes

Experts don’t know what causes cysts to form in the breasts. There is evidence that excess estrogen in the body may be a contributing factor. Breast cysts develop when fluid accumulates inside the glands in the breasts.

There are two basic classifications of breast cysts, related to their size: microcysts and macrocysts. Microcysts are too tiny to be felt, but they may be visible during imaging tests, like mammography or ultrasound. Macrocysts can be felt by touching the affected area of the breast. They can grow as large as 1 to 2 inches in diameter. When breast cysts are large, they can put pressure on adjacent breast tissue, which can cause discomfort and pain.

When should you see a doctor?

If you feel any new breast lumps and they do not go away after your period ends, call your doctor right away. While most breast cysts are usually not cancerous, it’s always a good idea to have any lump or cyst checked out by your doctor.

Breast Calcifications

Breast calcifications are a build up of calcium in breast tissue. This build up is called calcium deposits or calcifications. These calcifications cannot be felt during a normal breast exam, so they are usually detected and diagnosed during a routine mammogram. When breast calcifications are seen on a mammogram, they show up as white spots or flecks.

It’s not unusual for women to have breast calcifications – especially after menopause. Most of the time, calcifications aren’t cancerous. But when they appear in certain patterns or shapes, they may indicate precancerous changes to breast tissue or the presence of breast cancer.

Types of Breast Calcifications

There are two general classifications of breast calcifications – macrocalcifications and microcalcifications.

• Macrocalcifications appear as large white spots that looks like dashes or dots. They are rarely cancerous, and their presence does not require additional testing or follow up other than routine care.
• Microcalcifications appear as tiny white specks. They are also usually noncancerous, but if these tiny specks form certain patterns, they can indicate cancer or a pre-cancerous condition.

If your mammogram shows microcalcifications that appear questionable, your doctor may recommend a second mammogram to take additional views and get a closer look. If your doctor is still concerned after the second mammogram, he or she will likely recommend a breast biopsy to evaluate the calcifications and surrounding tissue.

Causes of Breast Calcifications

There are many conditions that can cause breast calcifications, including:

• beast cancer
• ductal carcinoma in situ (DCIS)
• mammary duct ectasia
• cell secretions
• fibroadenoma
• injury or trauma to breast tissue, including breast surgery
• previous radiation therapy
• calcification of the skin or blood vessels

If you use skin products that contain certain materials that are considered “radiopaque,” the radiopaque particles can look like calcifications on a mammogram. For that reason, you should not wear any deodorant or skin products before your mammogram.

When should you call your doctor?

Since you cannot feel breast calcifications or see them without the aid of mammography, your doctor will likely be the one reporting the presence of calcifications to you. If your doctor believes the calcifications could be a sign of cancer or ductal carcinoma in situ, he or she will follow up with you to talk about next steps.

The most important thing you can do to ensure that any breast calcifications are found and, if necessary, tested is to always get your recommended mammograms. Talk to your doctor about the mammography guidelines that apply to you.

Fibrocystic Breast Changes

Some women’s breasts have tissue that can feel fibrous, lumpy, or rope-like. This tissue is sometimes called glandular breast tissue. Having fibrocystic breasts is common – about half of menstruating women experience fibrocystic breast changes. After menopause, women may experience these changes if they are undergoing hormone replacement therapy. Having fibrocystic breast tissue is considered normal, and it is nothing to worry about. However, it can be more difficult to detect cancer in fibrous breast tissue. It’s vital for women to perform regular breast self-exams to get to know what their normal breast tissue feels like, so if there are changes, they will be likely to notice them.

Signs and Symptoms

Many women who have fibrocystic breasts don’t experience any pain or symptoms, but some women do report breast pain or tenderness and areas of lumpy tissue in the upper area of the breast and on the sides near the underarms. These symptoms, if experienced, tend to occur more just before menstruation.

Signs and symptoms of fibrocystic breasts can include:

• noticeable areas of thicker tissue
• breast pain or tenderness
• breast lumps that tend to grow and shrink throughout the menstrual cycle
• breast changes that seem to occur similarly in both breasts
• an increase in signs and symptoms from ovulation to just before menstruation (about two weeks out of the month)

What causes fibrocystic breast changes?

Experts aren’t sure what causes these changes, but they believe it’s due to hormones like estrogen.

When should you see a doctor?

While the changes associated with fibrocystic breasts are normal, there is some overlap in symptoms between fibrocystic breast changes and breast cancer. If you notice any of the following signs or symptoms, make an appointment to see your doctor.

• you detect a new breast lump or an area of thickening that seems prominent
• your breast pain is continuous or worsening
• the changes in your breasts continue after your period begins
• a previous lump that was evaluated and thought to be normal has changed in shape or size
• you experience nipple discharge that can be dark brown or green and may leak spontaneously without any pressure or squeezing applied to your breasts

If you are ever worried about a breast lump, breast pain or tenderness, or any other breast symptoms, don’t hesitate to call your doctor or make an appointment.

Get a Referral to a Beaumont Breast Care Doctor

Most breast cysts, calcifications and fibrous breast changes are not related to cancer. It’s still important to have your doctor evaluate you if you notice any areas of concern. And remember, some cysts and calcifications cannot be felt with a physical exam of the breasts, so it’s important to have mammograms as recommended by your doctor. Also, if you have any signs or symptoms of breast cancer, call your doctor right away. Some of those signs and symptoms are:

• skin changes on your breast, like redness, dimpling, crusting, or puckering
• one area of your breast is obviously different from the rest
• breast pain
• unexplained bruising on your breast
• your nipple is inverted or positioned abnormally
• lumps in your armpit or breast are getting bigger or changing shape – even if you have previously been diagnosed with breast cysts or fibrocystic breast changes

For a referral to a Beaumont breast care doctor, call 800-633-7377.