Breast Cysts and Calcifications: What You Need to Know

Breast blisters and calcification issues?

My mother had a mammogram during a community health check last month, and the report suggested that she should go to a major hospital for further examination, mentioning the presence of calcifications.
Therefore, we went to Chang Gung Memorial Hospital for a mammogram and ultrasound.
The technician for the mammogram indicated that there were calcifications, while the ultrasound doctor mentioned the presence of a cyst.
During the outpatient visit, the doctor only suggested considering surgery to remove the cyst to prevent future changes, without mentioning the issue of calcifications.

I have a few questions:
1.
Is the cyst a fibrocystic lesion? What is the typical management approach—surgery or other options?
2.
If surgery is necessary, will it involve removing just the cyst or the entire breast? Is this considered major surgery?
3.
The doctor did not address the management of the calcifications; does this mean they are not a concern?
I apologize for asking so many questions.
I was unable to accompany my mother on the day we reviewed the report, and she did not ask the doctor for detailed information, so I would appreciate your help in clarifying these concerns.
I am quite worried and anxious.
Thank you!

Xiao Jun, 20~29 year old female. Ask Date: 2013/07/10

Dr. Zhou Jiazhen reply Breast and Thyroid

Dear Xiao Jun,
Hello,
1.
The manifestations of fibrocystic changes are quite diverse, including pain, nipple discharge, and changes such as cysts and calcifications.
However, calcifications are often not visible on ultrasound.

2.
The management of cysts typically involves aspiration followed by cytopathological examination; surgical intervention is rare.
However, if there are recurrent cysts, surgery may be considered, usually involving simple excision of the cyst, after which the pathology report will determine if further breast tissue removal is necessary.

3.
Ultrasound often cannot detect microcalcifications.
If there is suspicion of malignancy, mammography can be used to localize the calcifications for core needle biopsy or excision.
Wishing you peace and health.
Sincerely,
Zhou Jiazhen
Director of Surgery, Taoyuan Hospital, Department of Health

Reply Date: 2013/07/10

More Info

Understanding breast cysts and calcifications can be a source of anxiety for many patients and their families, especially when faced with medical reports that suggest further evaluation. Here’s a comprehensive overview to help clarify these issues.

1. What Are Breast Cysts?
Breast cysts are fluid-filled sacs within the breast tissue. They can vary in size and may feel like a lump. The ultrasound report you mentioned indicates that your mother has a cyst, which is often benign (non-cancerous). Cysts can be classified as simple or complex. Simple cysts are typically filled with clear fluid and have smooth edges, while complex cysts may contain solid components or have irregular shapes, which can sometimes warrant further investigation.

2. Management of Breast Cysts
The management of breast cysts depends on their characteristics. If a cyst is simple and asymptomatic, it may not require any treatment. However, if the cyst is large, painful, or causing discomfort, aspiration (draining the fluid) may be performed. In some cases, if there are concerns about the cyst's nature or if it appears complex, a biopsy may be recommended to rule out malignancy.

Surgical intervention is generally reserved for complex cysts or if there are atypical findings on imaging or aspiration. The decision to proceed with surgery is based on the cyst's characteristics and the patient's symptoms. It is essential to have a thorough discussion with the healthcare provider about the risks and benefits of any surgical procedure.

3. Understanding Calcifications
Calcifications in the breast are small deposits of calcium that can be seen on a mammogram. They are common and often benign, but certain patterns of calcifications can be associated with breast cancer. The radiologist's report may indicate whether the calcifications are benign or if they require further evaluation.
If the calcifications are classified as suspicious, additional imaging studies, such as a breast ultrasound or MRI, may be recommended. In some cases, a biopsy may be necessary to determine the nature of the calcifications. The absence of mention regarding calcifications by the doctor could suggest that they are not of concern, but it is always best to clarify this with the healthcare provider.

4. Surgical Considerations
If surgery is recommended for the cyst, it is typically a minor procedure, often performed under local anesthesia. The goal would be to remove the cyst while preserving as much surrounding breast tissue as possible. A complete mastectomy (removal of the entire breast) is usually reserved for more severe cases, such as invasive cancer or extensive disease.

5. Follow-Up and Communication
It is crucial for your mother to have open communication with her healthcare provider. If there are uncertainties or concerns about the findings, she should feel empowered to ask questions. It may be helpful to prepare a list of questions before her next appointment to ensure all concerns are addressed.

Conclusion
In summary, breast cysts are generally benign and can often be managed conservatively. Calcifications require careful evaluation to determine their significance. If surgery is suggested, it is usually a minor procedure unless there are more serious underlying concerns. Encourage your mother to discuss her results and any uncertainties with her healthcare provider to ensure she receives the appropriate care and peace of mind. Regular follow-ups and monitoring are essential in managing breast health effectively.

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