Advisory by Kua Chong Han, Senior Patient-Care Pharmacist
Breast cysts are fluid-filled blisters occurring in the breast tissue and can develop anywhere within the breast. Cysts can be soft or hard, and vary in size. While some women may not be able to physically feel the cysts, they can be uncomfortable or even painful at times. They may become larger over time and may feel sore or tender prior to a menstrual cycle.
Having cysts in the breast/s may make one anxious. However, cysts may not be harmful and their presence does not necessarily mean an increased risk of developing breast cancer.
Cause
Cysts in the breasts are common and can affect women of all ages, particularly women between the ages of 45 and 50. Although the actual cause of cysts in the breast is unknown, they usually occur when a woman’s hormones are changing rapidly, particularly during menopause.
Cysts can decrease in size and may eventually disappear when menopause ends. Women who are on hormone replacement therapy (HRT) may be prone to cysts in the breasts as well.
Diagnosis
The cyst can usually be felt physically as a lump in the breast or detected during a routine mammogram screening. A physical examination and an ultrasound would generally be enough for your doctor to diagnose whether the presence of cysts needs further examination. Depending on the ultrasound results, your doctor may recommend a biopsy to further evaluate an abnormal solid-appearing mass.
Signs and symptoms of a breast cyst include:
- A round/oval-shaped breast lump (with distinct edges) that is smooth and is easily movable;
- Presence of clear, yellow or brown coloured nipple discharge;
- Pain or tenderness in the breast area where the lump is located;
- Increase in breast lump size/tenderness just before your menstrual cycle;
- Decrease in breast lump size after your menstrual cycle, coupled with resolution of accompanying signs and symptoms;
Breast cysts typically occur in one breast but can also affect both breasts concurrently.
Treatments
Usually, there is no need for any treatment or follow-up if you have a cyst in your breast as most cysts eventually disappear.
If the cyst is large enough to be felt or causes discomfort, the doctor will usually offer to drain the cyst with a needle (fine-needle aspiration). The cyst usually disappears once the fluid has been drained. Some discomfort may be felt as the fluid is being drawn off, and the area may feel tender and bruised for a few days, which can be relieved by taking painkillers such as paracetamol.
Taking oral contraceptives for regulation of menses may also help reduce breast cyst recurrence. However, oral contraceptives or other hormone therapies are usually recommended only to women who experience severe symptoms. Discontinuing HRT (during the postmenopausal years) may reduce the formation of cysts as well.
Other measures that can minimise discomfort of cysts in the breast/s include wearing a supportive and well-fitted bra, reducing caffeine and salt intake or taking over-the-counter pain medication. Some women may find taking evening primrose oil helpful in minimising menstrual cycle associated breast pain, although strong evidence of its efficacy is still lacking.
When to see a doctor
Normal breast tissues in a healthy woman will often feel lumpy or nodular. However, if you detect the presence of any new breast lump/s which do not go away over a period of time after a menstrual period, or if a previously evaluated breast lump worsens, check with your doctor immediately.
Lastly, having unusual changes in the breast/s can be upsetting and worrying for most women. However, after consulting a doctor, many women do feel relieved and recognise that changes in their breasts are a common occurrence and are not necessarily harmful.
Changes in the breast/s may also affect self-confidence or inter-personal relationships. Should such changes have a negative impact on your life, it might be helpful to share your feelings with supportive family members or friends.
