Fibrocystic Breast Changes: When to Seek Further Evaluation

Q: Fibrocystic Breast Changes: When to Seek Further Evaluation

Hello Ms. <br>BoBo： If you have concerns, you may consider a mammogram. <br>According to the American College of Radiology guidelines, if the imaging is classified as BIRADS 1-3, follow-up every six months is recommended (with a malignancy risk of less than 2%). <br>If it is BIRA

Fibrocystic breast changes

Hello Doctor, I would like to ask the following questions.
Thank you for the annual health check-ups I've had.
I learned that I have a 1 cm fibrocystic mass on the right side (which I cannot feel when I touch).
This year, while showering, I accidentally discovered a noticeable hard lump on the outer right side of my breast, resembling two round masses joined together, which is movable.
The next day, I immediately made an appointment with a breast surgeon.
During the consultation, an ultrasound was performed, and the doctor said that a new 1.7 cm fibrocystic mass had developed, which can be monitored without surgery.
I would like to ask the doctor the following questions: 1.
Is it normal for a new 1.7 cm cyst to suddenly develop within a year? 2.
Since the shape feels like two round masses connected together, does this count as having a regular shape? 3.
I would like to ask the doctor, since only an ultrasound was performed during the outpatient visit and no biopsy was done, would you recommend a biopsy in this situation? 4.
Given that the mass is 1.7 cm and has developed within a year, and is easily palpable, do you recommend surgical removal? I am very concerned.

BoBo, 20~29 year old female. Ask Date: 2022/04/06

Dr. Tang Yuxiong reply Surgery

Hello Ms.
BoBo: If you have concerns, you may consider a mammogram.
According to the American College of Radiology guidelines, if the imaging is classified as BIRADS 1-3, follow-up every six months is recommended (with a malignancy risk of less than 2%).
If it is BIRADS 4 or higher, a core needle biopsy is advised to rule out malignancy.
Alternatively, you may opt for ultrasound-guided vacuum-assisted breast excision, which can be performed in an outpatient setting to remove the tumor, resulting in a wound of only 0.3 cm.
After tumor removal, the specimen will be sent for pathological examination to confirm whether there are any abnormalities.
If you still have concerns regarding the above recommendations, you can schedule a consultation at our Women's Health Clinic.

Reply Date: 2022/04/06

More Info

Fibrocystic breast changes are a common condition that many women experience, characterized by the presence of lumps or cysts in the breast tissue. These changes can lead to discomfort, tenderness, and sometimes pain, particularly in relation to the menstrual cycle. Your concerns about the recent discovery of a new fibrocystic cyst and its implications are valid, and it’s important to understand the nature of these changes and when further evaluation may be necessary.

1. Growth of Cysts Over Time: It is not uncommon for fibrocystic changes to develop or change over time. The formation of a new cyst, such as the 1.7 cm cyst you mentioned, within a year can happen, especially considering the hormonal fluctuations that occur in a woman's body. These changes can be influenced by menstrual cycles, hormonal therapies, or other factors. While the appearance of a new cyst can be concerning, it is often a benign process. Regular monitoring is usually recommended, particularly if the cysts are asymptomatic.

2. Shape and Mobility of the Cyst: The fact that you describe the cyst as two round shapes that are movable is generally a reassuring sign. Cysts that are well-defined and mobile tend to be benign. In contrast, irregularly shaped or fixed masses may warrant further investigation. The regularity of the shape you described suggests that it is likely a benign cyst, but it is always best to follow up with your healthcare provider for personalized advice.

3. Need for a Biopsy: The decision to perform a biopsy typically depends on several factors, including the characteristics of the cyst, your medical history, and any associated symptoms. If the ultrasound shows typical features of a benign cyst, a biopsy may not be necessary. However, if there are any atypical features or if the cyst changes in appearance or symptoms develop, a biopsy may be recommended to rule out any malignancy. It’s essential to discuss your concerns with your doctor, who can provide guidance based on the specific ultrasound findings.

4. Surgical Intervention: Regarding whether to surgically remove the cyst, this decision is often based on symptoms, size, and the potential for changes in the cyst over time. If the cyst is causing significant discomfort or if there are concerns about its characteristics, your doctor may recommend surgical removal. However, if it is asymptomatic and appears benign, observation may be the best course of action. Regular follow-up with imaging may be suggested to monitor any changes.

In summary, while the presence of fibrocystic changes can be concerning, they are often benign and manageable. It is crucial to maintain open communication with your healthcare provider, who can help you navigate your concerns and determine the best course of action based on your specific situation. Regular monitoring and follow-up imaging are key components of managing fibrocystic breast changes, and any new symptoms or changes should be reported to your doctor promptly. Remember, being proactive about your breast health is essential, and seeking further evaluation when in doubt is always a wise choice.

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