Recurring Fibrocystic Cysts: Causes and Treatment Options

Fibrocystic recurrence

Hello Dr.
Lee, I apologize for bothering you.
In 2014, I consulted with a doctor who diagnosed me with a fibrocystic condition and I underwent an outpatient procedure.
However, since then, I have experienced continuous recurrences.
Each time, it starts with redness and swelling, followed by purulence.
Within less than a week, the pus-filled area ruptures, releasing a significant amount of green pus, leaving a deep circular wound.
I usually apply medication to it myself until it heals, but after a few months, the same situation repeats, always in the same location.
The timing of the recurrences varies, and they can even occur outside of my menstrual period.
On August 11, 2016, I switched to a different doctor who arranged for hospitalization and performed an abscess excision surgery.
It has been over a month since the surgery, and I have started to notice a hard lump near the wound, which has become red and swollen.
It is painful even without touching it.
I would like to ask the doctor: 1.
Is it normal for fibrocystic conditions to keep recurring and produce pus? 2.
The fibrocystic condition is located in the upper right area, but I feel pain in the lower left area each time.
Is this normal? 3.
The hard lump and redness near the surgical site, along with the pain, seem to indicate there might still be pus.
Does this mean the surgery was not thorough? 4.
The doctor mentioned that fibrocystic conditions are related to my constitution, so is it impossible to completely cure it or prevent frequent recurrences? I apologize for asking so many questions.
Thank you, doctor.

Miss Lin, 10~19 year old female. Ask Date: 2016/10/08

Dr. Li Zhonghuai reply Surgery

Hello!
1.
Is it normal for a fibrocystic cyst to keep recurring and produce pus? ==> Is there a pathology report? Is it confirmed to be a fibrocystic cyst?
2.
The fibrocystic cyst is located in the upper right, but I feel pain in the lower left each time.
Is this kind of pain normal? ==> This is due to the nerve pathways in the breast.

3.
There is a hard lump near the surgical site that is red, swollen, and looks somewhat like pus.
Does this mean the area was not cleaned properly during surgery? ==> This may indicate a case of purulent mastitis.
Currently, the main treatment method is debridement followed by drainage tube placement.
If drainage is ineffective, it may need to be changed to gauze packing for abscess drainage.
Sometimes, while treating one area, a new abscess may appear in another area.
As for whether it was cleaned thoroughly, excessive debridement can lead to breast deformity, so the approach must be adjusted based on the situation.

4.
The doctor said that fibrocystic cysts are a constitutional issue, so is it impossible to cure them or prevent them from recurring so frequently? ==> This needs to be treated as mastitis.
Without a pathology report, it is not possible to determine if it is indeed a fibrocystic cyst.

Take care! Changhua Hospital cares about you!

Reply Date: 2016/10/08

More Info

Recurring fibrocystic cysts, often referred to as fibrocystic breast changes, can be a source of significant discomfort and concern for many individuals. These cysts are typically benign and are characterized by the presence of fluid-filled sacs in the breast tissue. However, when they become recurrent and lead to complications such as infection and abscess formation, as described in your situation, it is essential to understand the underlying causes and explore treatment options.

1. Understanding Recurrence and Symptoms: It is not uncommon for fibrocystic cysts to recur, especially if they have been previously drained or surgically removed. The recurrence of symptoms such as redness, swelling, and purulent discharge indicates that there may be an underlying issue, such as infection or inflammation. The presence of greenish pus suggests that there may be a bacterial infection that needs to be addressed. It is crucial to differentiate between simple cysts and those that may be infected or complicated by abscess formation.

2. Pain and Location of Symptoms: The fact that you experience pain in a different area from where the cysts are located can be perplexing. This phenomenon can occur due to referred pain, where pain is perceived in a different location than its source. It is also possible that the cysts or any associated inflammation can irritate surrounding tissues, leading to pain in adjacent areas. A thorough examination by a healthcare provider is essential to assess the situation accurately.

3. Post-Surgical Complications: The development of a hard lump, redness, and pain near the surgical site may indicate several possibilities, including incomplete removal of the cyst, the formation of a new cyst, or the development of a post-surgical infection. It is crucial to follow up with your healthcare provider to evaluate the surgical site and determine if further intervention is necessary. Imaging studies, such as an ultrasound, may be helpful in assessing the area for any residual cysts or abscesses.

4. Underlying Causes and Management: Fibrocystic changes are often linked to hormonal fluctuations, particularly estrogen. While they are not typically considered a serious health concern, they can cause discomfort and recurrent issues. Management strategies may include hormonal therapy, lifestyle modifications, and in some cases, surgical intervention. Your healthcare provider may recommend medications to help regulate hormonal levels or other treatments to manage symptoms.

5. Preventive Measures: While it may not be possible to completely prevent the recurrence of fibrocystic cysts, certain lifestyle changes may help reduce their frequency and severity. These can include dietary modifications, stress management techniques, and regular monitoring of breast health. Maintaining a healthy lifestyle and being aware of any changes in your breast tissue can empower you to seek timely medical advice.

In conclusion, while recurring fibrocystic cysts can be frustrating and painful, they are generally manageable with appropriate medical care. It is essential to maintain open communication with your healthcare provider, report any new or worsening symptoms, and adhere to follow-up appointments to ensure that any complications are addressed promptly. Your health and comfort are paramount, and with the right approach, you can find relief from these recurrent issues.

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