For some people, cysts can feel uncomfortable and even painful. Before a period, cysts may become larger and feel sore and tender as hormone levels change. However, many women can have cysts and not be able to feel them at all. Breasts are made up of lobules milk-producing glands and ducts tubes that carry milk to the nipple.
The milk glands are surrounded by fibrous support tissue and fat, known as breast tissue. This tissue gives breasts their size and shape. Sometimes, the milk glands can fill up with fluid; these are breast cysts. Cysts may appear naturally as the breast alters with age, due to normal changes in the oestrogen hormone levels. During the menstrual cycle oestrogen causes fluid to be produced. After the menopause when your periods stop , as oestrogen levels fall, cysts usually stop forming. Women who have hormone replacement therapy HRT may still get cysts.
Cysts usually become noticeable as a lump in the breast or are found by chance during a routine screening mammogram breast x-ray or while having investigations at a breast clinic for another reason. Breast cysts are very common. Cysts can develop in women of any age. They are most common in the 30—50 year age group. They usually disappear after menopause, but in some women they can last throughout life.
Cysts are more common in post-menopausal women who take hormone replacement therapy than in post-menopausal women who do not.
All of these factors support the theory that breast cysts are hormonally responsive, although it is not clear why some women form cysts and others do not. Most breast cysts are tiny only a few millimetres in diameter and they cause no symptoms. Often they are seen on a mammogram or ultrasound study that has been performed for another reason. On a mammogram, they can sometimes be seen as a smooth, round mass in the breast tissue.
On ultrasound, they are usually smooth, round and black. Sometimes cysts do not have these typical features and they are difficult to distinguish from solid non-fluid lesions just by looking. These may need further testing to confirm they are cysts. When cysts become large they can cause a lump that can be felt.
Classically, the lump is smooth, soft, and moves easily, although if the fluid is under tension, it can feel firm when examined. The doctor might ask you to come back for a check-up in a couple of months. Many women have cysts that come back. These might be cysts that refill with fluid or they might be new cysts.
Recurring cysts are not dangerous. They are treated the same way as the first cyst. If you have a cyst drained and the lump refills within 24 hours, you should make an appointment to see the doctor again. Your cyst does not put you at any increased risk of breast cancer. You should follow the recommendations for breast cancer screening for women of your age and family history.
All women need to be alert to any changes in their breasts that are not normal for them. If you have any change in your breast that is different to your usual hormonal changes, you should have it checked by your General Practitioner GP. For most women, having an unusual breast change is upsetting.
It can bring up many different feelings and worries. Most of the time women feel relieved to know that their breast change is due to a common condition that is not harmful or dangerous.
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