Fibrocystic Changes: When to Consider Surgical Intervention

Fibrocystic changes

Hello, doctor.
I have a predisposition to fibrocystic changes (cysts) and have been experiencing this since middle school.
There is no family history of breast cancer, and I have been undergoing regular check-ups every six months.
On October 21, I discovered multiple cysts in both breasts, nearly ten in total.
One of these cysts felt larger when I checked again on November 28, growing from 0.5 cm to nearly 1.2 cm in just one month, and its shape changed from oval to slightly irregular.
The doctor suggested a minimally invasive procedure to remove it and perform a biopsy to prevent future growth.
However, I had already undergone a minimally invasive excision of a 1.5 cm fibroadenoma in early May this year, and I am hesitant about undergoing another procedure.
Given the rapid growth in such a short time, would you recommend that it be excised? I would like to hear your advice.
Thank you.

Miss Lu, 20~29 year old female. Ask Date: 2023/11/29

Dr. Chen Bingze reply Surgery

It is advisable to conduct a tissue biopsy for safety when rapid growth occurs in a short period of time, as no one can guarantee that everything is fine without proper testing.

Reply Date: 2023/11/29

More Info

Fibrocystic changes in the breast, characterized by the presence of cysts and fibrous tissue, are common and often benign. However, when cysts exhibit rapid growth or changes in shape, as you described, it raises concerns that warrant further evaluation. In your case, the cyst that increased from 0.5 cm to nearly 1.2 cm within a month and changed from an oval to a slightly irregular shape is particularly noteworthy.

The recommendation from your physician to consider a minimally invasive procedure to remove the cyst for further examination is prudent. Rapid growth and changes in the characteristics of a cyst can sometimes indicate the need for closer scrutiny, as these changes may be associated with atypical or malignant processes, even in the absence of a family history of breast cancer.

When considering surgical intervention, several factors come into play:
1. Rate of Growth: The speed at which the cyst has grown is a significant factor. A rapid increase in size, especially in a short time frame, can be a red flag. While many fibrocystic changes are benign, rapid growth can sometimes indicate a need for further investigation.

2. Shape and Texture Changes: The change in shape from oval to irregular is another important consideration. Benign cysts typically maintain a consistent shape, while irregularities can suggest potential issues that may require biopsy or removal.

3. Previous History: Since you have already undergone a procedure for a fibroepithelial lesion (fibroadenoma), your history may influence the decision-making process. If you have a history of benign lesions, it’s essential to monitor any new changes closely.

4. Symptoms: If you are experiencing discomfort, pain, or other symptoms associated with the cysts, this can also be a factor in deciding whether to proceed with surgery.

5. Follow-Up and Monitoring: Regular follow-up is crucial. If you choose not to proceed with surgery immediately, ensure that you have a clear plan for monitoring the cysts, including regular imaging and clinical evaluations.

In general, the decision to surgically intervene should be made collaboratively with your healthcare provider, taking into account your specific circumstances, including your medical history, the characteristics of the cysts, and your personal preferences. If the physician believes that the benefits of removing the cyst outweigh the risks, it may be advisable to proceed with the surgery.

In summary, while fibrocystic changes are common and often benign, any significant changes in size or shape should be taken seriously. Surgical intervention may be warranted to ensure that any potentially atypical or malignant changes are addressed promptly. It is essential to have an open discussion with your healthcare provider about your concerns, the risks and benefits of surgery, and the best course of action for your situation. Regular monitoring and proactive management are key to maintaining breast health.

Similar Q&A

Understanding Fibrocystic Breast Changes: To Remove or Not?

Hello Dr. Lin: I previously consulted you about my condition, and I have since undergone examinations at the hospital. The doctor diagnosed it as a fibrocystic breast condition. However, I am unsure whether I need to have it surgically removed. If I do have it removed, will it gr...

Dr. Lin Kecheng reply Surgery
Fibrocystic changes are benign tumors of the breast. If a cyst measures 0.9 centimeters, it is recommended to perform a breast aspiration for cytological examination to confirm the diagnosis as a fibrocyst or something else. Generally speaking, if surgically removed, it is unlike...

Understanding Fibrocystic Breast Changes: Surgery and Aesthetic Concerns

Recently, a fibrocystic mass measuring 2.5 centimeters was found in my breast. Will surgery affect the appearance? If surgery is required, will I need to be hospitalized? Thank you.

Dr. Wang Zhitang reply Surgery
A 2.5 cm benign breast mass excision generally does not affect the appearance of the breast (aside from scarring). Most of these breast biopsy surgeries are performed under local anesthesia, allowing the patient to go home immediately after the procedure without the need for hosp...

Understanding Fibrocystic Breast Changes: When is Surgery Necessary?

Hello, doctor. I have a breast fibrocystic condition. A few days ago, I went for a routine follow-up on the fibrocystic changes, and the doctor mentioned during the ultrasound examination that there was a cyst with something growing inside it, indicating it was a stage 5 cyst tha...

Dr. Cai Xingzhi reply Surgery
Hello, breast cysts typically decrease in size about a week after menstruation. At this time, an ultrasound examination will be more accurate in determining whether surgery is necessary. It is advisable to consult a breast surgeon to evaluate the results before making a decision.

Understanding Fibrocystic Changes: Should You Treat Underarm and Breast Cysts?

Should fibrocystic changes in the axilla and breast be treated? What are fibrocystic changes?

Dr. Li Mingjie reply Surgery
Chen: Hello, fibrocystic changes are benign breast conditions, and the chance of them turning malignant is extremely low. Additionally, symptoms often improve after menopause. Therefore, they generally do not require special treatment, only monitoring and symptomatic management.