ARE BREAST CYSTS A CONCERN?

Sometimes fluid can accumulate inside glands in breast tissue and form cysts. Breast cysts are fluid-filled sacs, which are usually benign (noncancerous). They do not increase your risk of developing breast cancer, and often don’t require treatment.

Breast cysts are the most common type of breast lumps in women between the ages of 30 and 50. It’s unknown what causes cysts to form but their development seems to be related to hormonal changes, often occurring around a menstrual cycle.

While most cysts improve on their own, a cyst that is large and uncomfortable may need to be treated. It’s important to speak with your doctor about any changes in breast tissue, including new lumps – especially ones that are painful.

HOW ARE BREAST CYSTS DIAGNOSED?

To investigate any breast concern, your doctor will likely order medical imaging, such as mammography, breast ultrasound, or both together.

Mammography uses X-ray technology to create a detailed picture of the internal structure of breast tissue. This exam can help spot a breast cyst or an area that needs further investigation.

A breast ultrasound uses high-frequency sound waves to help determine the composition of a lump or area of concern, distinguishing between a cyst, fibroglandular tissue, and a solid mass. The pitch, direction, and distance sound waves travel differ depending on what they run into (e.g., tissue, fluid, bone). A computer can interpret this information as a two-dimensional image on a screen and provide information about the area of concern.

For example, a breast ultrasound can help determine whether the cyst is filled with fluid, solid areas, or a combination of both. By examining the features of the cyst as presented on the ultrasound image, the radiologist can assess whether the cyst has features that may be concerning and might require a biopsy.

A biopsy is a procedure that removes small pieces of tissue from within the breast. A needle is guided into the cyst to take a small tissue sample, which is sent to a laboratory for analysis.

HOW DOES HAVING BREAST CYSTS AFFECT REGULAR BREAST SCREENING?

Regular breast cancer screening through mammography is considered the best way to assess the health of breast tissue and catch breast cancer early in its early, most treatable stage.

Breast cysts don’t increase your risk of breast cancer, but they may complicate breast screening if you have them or develop them regularly. On a mammogram, breasts cysts may make it challenging to monitor or find changes in breast tissue. For this reason, it’s recommended that you:

• Understand what’s normal for you, especially during your menstrual cycle.
• Speak to your doctor about any changes or new concerns, such as new lumps, pain, skin changes, nipple discharge, etc.

If you have breast cysts or develop them regularly, your doctor may recommend yearly breast screening that includes both mammography and breast ultrasound.

WHAT HAPPENS DURING BREAST IMAGING?

During mammography, the machine will gently press down on the breasts to spread the breast tissue out and capture a more complete picture of each breast. The pressure lasts for a few seconds, while the machine quickly takes a number of pictures. Then the process will be repeated for the other breast. It may be a bit uncomfortable, but it’s very quick, only 10 or 15 minutes in total.

All Mayfair Diagnostics’ mammography clinics use technology that provides 3D images (tomosynthesis) of the breast that can then be viewed in slices. This provides a greater level of detail and a clearer view of the breast tissue with a very small dose of radiation.

You may also be sent for a breast ultrasound. For this exam, a warm, non-scented, hypo-allergenic ultrasound gel will be applied to breast tissue, one breast at a time. The sonographer moves the handheld probe slowly over all areas of each breast and into the armpit area to provide a complete set of images. This exam can take up to an hour to scan both breasts.

For both exams, you may want to let your technologist know the location of any lumps or areas of pain.

Once the mammogram and/or breast ultrasound images have been taken, one of our radiologists will look over them very carefully to check for possible abnormalities or changes compared to previous ultrasounds or mammograms.

HOW DO I GET BREAST IMAGING?

Many people start having regular mammograms every year at age 40, since Alberta Health Care covers one mammogram per year starting at that age. The Canadian Association of Radiologists and Mayfair Diagnostics recommend screening mammography every year from age 40 to 49, then every two years between age 50 and 75, if there are no risks factors that would necessitate a shorter interval. After age 75, screening frequency will depend on many factors, including your medical history.

Refer to the Alberta and Saskatchewan provincial breast screening programs for their screening recommendations.

If you have pain or a concern about your breasts or to start breast screening, you will need to speak to your doctor about your family history, your medical history, whether mammography alone or with breast ultrasound is needed, and how frequently you should be screened.

If your doctor hasn’t told you that you need a mammogram, you can still book your exam. You don’t always need a doctor’s requisition to book a screening mammogram. In certain instances, you are able to self refer. See mammogram self-referral guidelines.

Mayfair Diagnostics has 14 locations which offer mammography exams, and except for our Coventry Hills all of them use the Senographe Pristina mammography system – which helps provide a more comfortable mammogram. Visit our breast imaging page for more information.

REFERENCES

Alberta Health Services (2021) “Breast Screening.” screeningforlife.ca. Accessed April 23, 2024.

Canadian Cancer Society (2024) “Breast cysts.” cancer.ca. Accessed April 17, 2024.

Fox, K. (2024) “Breast Cysts.” breastcancer.org. Accessed April 17, 2024.

Mayo Clinic Staff (2024) “Breast cysts.” mayoclinic.org. Accessed April 17, 2024.

Sask Cancer Agency (2024) “Screening Program for Breast Cancer.” saskcancer.ca. Accessed April 23, 2024.