Breast cancer

Updated 13 November 2017

Breast cysts and how they are diagnosed

As women get older, their breasts naturally develop cysts. How are they diagnosed and when should you worry about a cyst?

As a woman gets older, her breasts naturally develop cysts. These are usually simple cysts and not associated with breast cancer. They can be clearly seen on ultrasound.

How can you diagnose a cyst?

The triple test:

  • Clinical assessment: the lump usually has sharp borders and is firm. It is freely mobile over the overlying muscle and under the skin. Cysts may become large but can usually be felt once they are 2 cm in size.
  • Imaging: A cyst shows up as a clear circle on the mammogram. If there are multiple cysts, there may be some areas of calcification on the mammogram. These may cause confusion with pre-cancerous changes and should be removed if that is the problem.
  • Aspiration: If a needle is put in a cyst and the fluid aspirated (pulled out with a needle), the fluid is usually a yellow-green colour. If there is evidence that it is blood stained, the fluid should be sent off for examination under a microscope. The lump should disappear completely when the fluid has been removed.

When do you worry about a cyst?

  • If the fluid is blood stained
  • If the ultrasound shows there is a lump in the cyst
  • If there is still a lump after the fluid has been removed
  • If the lump comes back quickly and repeatedly after aspiration
  • If there are calcifications on the mammogram that look suspicious
  • If any of the tests suggest it is not a simple cyst

If in doubt the area should be removed.


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Ask the Expert

Breast cancer expert

Dr Gudgeon qualified in Birmingham, England, in 1968. She has more than 40 years experience in oncology, and in 1994 she founded her practice, Cape Breast Care, where she treats benign and malignant breast cancers. Dr Boeddinghaus obtained her qualification at UCT Medical School in 1994 and her MRCP in London in 1998. She has worked extensively in the field of oncology and has a special interest in the hormonal management of breast cancer. She now works with Dr Gudgeon at Cape Breast Care. Read more.

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