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Tests and diagnosis
By Mayo Clinic staffScreening and diagnosis of a breast cyst usually begins after you or your doctor has identified a breast lump. The process may involve the following tests or exams:
- Clinical breast exam. Your doctor physically examines the breast lump and checks for any other problem areas in your breasts. Questions to anticipate include when you first noticed the lump, whether its size has changed, if you have any breast pain associated with the breast lump, whether you have nipple discharge and how your menstrual cycle affects the lump. However, your doctor can't tell from a clinical breast exam alone whether a breast lump is a cyst, so you'll need another test, either an ultrasound or fine-needle aspiration — or maybe both.
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Breast ultrasound. Breast ultrasound can help your doctor determine whether a breast lump is fluid-filled or solid. The radiologist — a doctor who specializes in imaging methods — performing the ultrasound makes this determination based on certain characteristics seen during the imaging exam. A fluid-filled area usually indicates a breast cyst. A solid-appearing mass most likely is a fibroadenoma, but it could also be breast cancer.
Some doctors skip breast ultrasound and perform fine-needle aspiration instead.
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Fine-needle aspiration. During this procedure, your doctor inserts a thin needle into the breast lump and attempts to withdraw (aspirate) fluid. If fluid comes out and the breast lump goes away, your doctor can make a breast cyst diagnosis immediately.
Unless there appears to be blood in the fluid, it requires no further testing or treatment after draining. If the fluid is bloody, a laboratory may need to test it. Lack of fluid or a breast lump that doesn't disappear after aspiration suggests that the breast lump — or at least a portion of it — is solid, and a sample of cells may be collected and sent for analysis to check for the presence of cancer (fine-needle aspiration biopsy).
Mammography usually isn't indicated for a breast cyst. However, you may undergo a mammogram if your doctor suspects, during the course of evaluating your breast lump, that the lump is caused by something other than a breast cyst.
