Breast Cysts: When to Seek Further Medical Advice

Breast issues

Hello, Doctor.
On November 10, I experienced pain when pressing on the right side of my right breast, so I went to the hospital for a breast examination.
The doctor told me it was a cyst, with a little bit present in both breasts, and there seemed to be some calcification.
I asked if it was a fibrocystic cyst, but the doctor didn't clearly specify what type of cyst it was.
He mentioned that if there were no discharge from the breast or symptoms like peau d'orange (orange peel skin) after returning home, I should come back for a follow-up in three months.

A week or two after seeing the doctor, I noticed a more pronounced pain on the right side of my right breast, but it only hurts when pressed.
I'm not sure if it's because I've maintained the same posture for too long, as I sometimes feel a brief pain when getting up or moving.
However, if I don't intentionally press on it, I don't feel anything.
From November 26 to December 1, during my menstrual period, I hardly felt anything in my right breast.
Since my period ended, I haven't experienced any pain unless I deliberately press on the right side, which gives me a very subtle sensation of "it seems to hurt a little," but it's quite mild—it's a sensation that could be described as pain or not pain.
I would like to ask if I need to go to another hospital for further examination.
I have looked up some articles online, and since I rarely go for medical check-ups, I'm worried about the possibility of misdiagnosis.
Is there a chance this could develop into breast cancer or another serious issue? Thank you for your guidance.

Xiao Mi, 20~29 year old female. Ask Date: 2020/12/08

Dr. Chen Jiaming reply Surgery

Women in their 20s to 30s often experience breast tenderness associated with their menstrual cycle due to increased ovarian hormone secretion.
During this time, ultrasound examinations typically reveal what is known as fibrocystic changes, which are imaging alterations caused by numerous normal glandular tissues in the breast, rather than a single larger fibrocyst.
Most cases of breast tenderness in young women stem from this condition and do not warrant excessive concern.
Although the incidence of breast cancer is high and becoming more common among younger women in Taiwan, the peak age remains in the 40s to 50s, with a lower incidence in women in their 30s, and even less so in those in their 20s.
It is recommended that you return for a follow-up appointment in three months.
If there are no other abnormalities, you can schedule annual breast ultrasound examinations after turning 30, along with performing simple monthly self-examinations, which should be sufficient for detecting any breast conditions.

Reply Date: 2020/12/08

More Info

Understanding breast cysts and when to seek further medical advice is crucial for maintaining breast health and addressing any potential concerns. Based on your description, it seems you have been diagnosed with breast cysts, which are fluid-filled sacs that can develop in the breast tissue. These cysts are generally benign (non-cancerous) and are quite common, especially in women of reproductive age.
From your account, it appears that your doctor has advised you to monitor your symptoms and return for follow-up in three months if there are no concerning signs such as discharge from the nipple or changes in the skin texture (like "orange peel" appearance). This is standard practice, as many breast cysts do not require immediate intervention unless they cause significant discomfort or show signs of complications.

The pain you are experiencing, which seems to be linked to pressure or specific movements, is not uncommon with breast cysts. Hormonal fluctuations, particularly around your menstrual cycle, can also influence breast tenderness and cyst size. It’s worth noting that cysts can sometimes become more prominent or painful just before menstruation due to hormonal changes.

When to Seek Further Medical Advice
1. Persistent or Worsening Symptoms: If the pain becomes more intense or persistent, or if you notice any new symptoms such as a lump that feels different from the cysts previously identified, it would be prudent to seek further evaluation.

2. Changes in the Cyst: If you notice any changes in the cysts themselves, such as an increase in size or changes in shape, this warrants further investigation.
3. Nipple Discharge: Any unusual discharge from the nipple, especially if it is bloody or clear and persistent, should be evaluated by a healthcare professional.

4. Skin Changes: As mentioned, if you observe any changes in the skin over the breast, such as dimpling, puckering, or a change in color, these could be signs of a more serious condition and should be assessed promptly.

5. Family History: If you have a family history of breast cancer or other breast diseases, you may want to discuss this with your doctor, as it may influence your monitoring and screening schedule.

Anxiety and Misdiagnosis Concerns
It’s natural to feel anxious about the possibility of misdiagnosis, especially when it comes to breast health. However, breast cysts are typically straightforward to diagnose through imaging studies like ultrasound or mammography. If you have concerns about the accuracy of your diagnosis, seeking a second opinion can provide peace of mind.

Regular Monitoring
Regular follow-ups are essential, especially if you have been advised to return for monitoring. Keeping track of any changes in your breast health, including the size and tenderness of cysts, can help your healthcare provider make informed decisions about your care.

Conclusion
In summary, while your current symptoms do not seem to indicate an immediate cause for concern, staying vigilant and maintaining open communication with your healthcare provider is key. If you feel uncertain or anxious about your diagnosis or symptoms, don’t hesitate to seek further evaluation or a second opinion. Breast health is an important aspect of overall well-being, and being proactive about any changes is always a wise approach.

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