Breast cysts are extremely common, particularly in women aged 35-50. They are thought to develop in response to normal hormonal changes in the body. Women who have fibrocystic breast tissue are more likely to develop breast cysts. Cysts are more commonly seen beginning around age 35 due to the onset of these hormonal changes. Breast cysts do not tend to develop after menopause unless you are taking hormone replacement therapy (HRT), in which case the HRT may cause post-menopausal cyst development.
Cysts occur at the junction between the milk-producing glands and the milk ducts. Women can develop a single cyst, multiple cysts in one breast, or cysts in both breasts. The cysts are filled with a clear/yellowish fluid. Most cysts are too small to feel, but if large enough you may feel a lump in your breast. The lump most often is soft with defined edges, similar to a water-filled balloon. However, breast cysts may also be firm to the touch.
If the cysts are large enough for you to feel, it is common to notice changes in them. Here are some examples of how cysts may change over time due to normal hormonal stimulation:
- Increase in size
- Decrease in size
- Resolve (you can no longer feel it)
- Develop new cysts in new locations
It can be tempting for women who develop multiple cysts to assume that a new lump in the breast is just a new cyst. And in all likelihood, this is the case. To be clear– breast cancer WILL NOT develop from a simple fluid-filled breast cyst. However, breast cancer may develop next to a cyst or in another area of the breast. Because of this, vigilance is encouraged with monthly self-breast exams and further evaluation of all new breast lumps by both your primary care provider and with diagnostic imaging to evaluate for possible breast cancer. Cysts will be classified as “simple cysts” (this is the term used in breast imaging reports to describe the benign breast cysts related to hormone stimulation) based on the imaging appearance as seen with ultrasound.
It is not necessary to have breast cysts drained or surgically removed. However, some women have large cysts which cause considerable breast discomfort and/or pain. In these cases, a needle may be inserted into the cyst under ultrasound guidance (similar to an ultrasound-guided breast biopsy) to drain the fluid to alleviate the breast symptoms. Unfortunately, the lining of the cyst remains after needle drainage. Fluid may reaccumulate within the cyst cavity resulting in the return of the original breast symptoms. Bottom line– cyst drainage can help alleviate breast symptoms in the short term, but this is not always a long-term cure.
Although there is no medical cure for developing breast cysts, there are a few things that may help decrease the symptoms related to breast cysts:
- Work with your primary care provider to decrease HRT dose.
- Decrease or eliminate caffeine consumption. There is no clinical evidence that caffeine consumption is related to cysts, however, many women report improved symptoms after decreasing caffeine consumption.
- Decrease salt consumption. As with caffeine, there is not a conclusive link between salt consumption and breast cysts. However, there are reports that salt reduction does help alleviate breast cyst symptoms.
- Wear a supportive bra.
Points to remember about breast cysts:
- They are extremely common.
- Cysts do not turn into cancer.
- There is no cure, however, there are lifestyle changes that may help alleviate the symptoms related to breast cysts.
- All new breast lumps should be evaluated by your primary care provider and with diagnostic imaging to evaluate for possible breast cancer.