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Complex Cysts
Questions about complex breast cysts.
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AskedPublicly Submitted Question
5/7/2017I asked the question below back in March. I saw the breast specialist and she did not seem concerned at all about the US results. She did not know why they suggested a 3 month follow-up and said that I should just do 6 months follow up with mammogram (I would be due anyway, but I kind of feel it's a waste given it has never shown anything but dense breasts) and US and see her again at that time. She did bring up genetic counseling as a possibility given my extensive family cancer history. But I feel uneasy about the lack of any additional testing now given the US report. Should I pursue another opinion or just follow up with the repeat testing in 6 months?

3/25/2017 Ultrasound for dense breasts classified as BI-RADS 3 showed 4 areas in the right breast and one in the left which may be solid mass or complicated cysts. Each is worded slightly differently which is hard to interpret.
-Rounded structure with internal echoes and mild enhanced through transmission which may be a solid mass or complicated cyst
- hypoechoic structure which may be a solid nodule vs complicated cyst
- hypoechoic structure with internal echoes and enhanced through transmission which is likely complicated cyst
- sharply defined hypoechoic structure with enhanced through transmission which is likely a simple cyst
- hypoechoic structure with internal echoes and no acoustical shadowing which may be a complicated cyst or solid mass.
- additional simple cysts also present in both breasts

I have a history of ductal papilloma also which was monitored but never excised. The recommendation was for short-term followup in 3 months but my gynecologist said if I was more comfortable I could see a breast specialist now, so I am doing that (same one who followed the papillomas). I am confused about all this but thinking of pushing for biopsy. Is this the best course?

As an addition - my mother has had a history of breast cysts also and a recent phyllodes tumor. There is a strong history of cancer in my family but not breast cancer - however 2 sisters with ovarian and uterine cancer. My youngest sister recently passed away due to an aggressive sarcoma, which I realize is unrelated but it is making me highly anxious about cancer. I'd also like to request genetic testing but am not sure if that will be supported.

Replied JHU's Breast Center Reply
3/25/2017 this likely warrants more imaging and possibly a biopsy so pursue it
RepliedJHU's Breast Center Reply
5/7/2017make sure the radiologist was and si a breast imaging radiologist as this increases the odds for accuracy when interpretating breast imaging studies. request information from the radiologist about how dense is the breast tissue. this helps in knowing how easy or not easy it is to see objects within the breast tissue. usually someone in the family who has already been diagnosed with breast or ovarian cancer gets the genetic testing first. if positive, then it is smart for other first degree relatives to consider testing too. it does take usually 6 months to see ia change on a mammogram, if one were to develop a change.

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