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Found a complex cyst but no biopsy ordered ?
Hi everyone!
I’m 35f with some family history of breast cancer so I started to do annual mammogram and ultrasound because I have dense breasts
Anyways I had both yesterday and breast specialist said everything looked fine and to schedule next year
But I noticed in my results after reading them it a part says “ complex appearing cyst or cyst cluster”
Don’t those require a biopsy?
Assessment at the end says
ASSESSMENT:
ACR BI-RADS: BI-RADS Category 2 - Benign. Benign findings without features of
malignancy (Overall)
Dig Dx Tomo: BI-RADS category 2 - benign. Benign findings without features of
malignancy in both breasts.
US Breast LTD: BI-RADS category 2 - benign. Benign findings without features
of malignancy.
Is it possible she missed the part about there possibly being a. Complex cyst and I actually need a biopsy ?
I will attach full results in a comment
Thank you.
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MA Mammogram Diag Dig Tomo Bil: January 21, 2025 - Check In #: 18042973
2D/3D Procedure
Prior study comparison: April 5, 2024, bilateral MA mammogram diag dig tomo
bil, performed at Women's Center for Breast Health. April 5, 2024, MA US
breast limited bilateral, performed at Women's Center for Breast Health.
Bilateral CC and MLO views were obtained with tomosynthesis. Additionally,
bilateral laterally exaggerated cc views were performed. Heterogeneously dense
fibroglandular tissue remains present with some underlying fibrocystic changes
evident. No suspicious appearing nodules otherwise identified. No suspicious
microcalcifications, no other new indirect signs of malignancy.
MA US Breast Limited Bilateral: January 21, 2025 - Check In #: 18042974
Bilateral whole breast sonography performed at the Bartlett breast care center.
Some fibrocystic changes are evident along with several small cysts. Within
the right breast at 10 o'clock position 4 cm from the nipple there is a complex
appearing cyst or similar cyst cluster measured at 11 byx 8 x 11 mm no.
Within the left breast at 1 o'clock position 2 cm from the nipple there is a
small cystic cluster measuring 8 x 7 x 7 mm. Several other cysts, larger cysts
and cyst clusters present on 4/5/2024 ultrasound are no longer present.
ASSESSMENT:
ACR BI-RADS: BI-RADS Category 2 - Benign. Benign findings without features of
malignancy (Overall)
Dig Dx Tomo: BI-RADS category 2 - benign. Benign findings without features of
malignancy in both breasts.
US Breast LTD: BI-RADS category 2 - benign. Benign findings without features
of malignancy.
Recommendation
Routine screening mammogram at age 40.
Risk Value(s):
Tyrer-Cuzick 10 Year: 2.100%, Tyrer-Cuzick Lifetime: 24.900%, Myriad Table:
2.6%, GAIL 5 Year: 0.5%, NCI Lifetime: 18.1%
@iza1989
Welcome to Mayo Connect, for the most part, we are not medical professionals, instead we are patients and caregivers sharing experiences, asking advice and supporting each other.
Radiology imaging reports can be very technical and hard to interpret.
I understand your concern about cyst, especially with your family history.
Do you have a follow appointment with your provider to help you understand results? Ask about a biobsy or a if a MRI should be schedule due to dense breast.
Another suggestion, based on family history, has anyone suggested genetic testing?
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3 ReactionsHello! I have don’t genetic testing and all is negative, she said only follow up next year for annual mammo and ultrasound
Birads 2 score means benign but I’m just confused about the possible complex cysts
You may find this helpful
https://www.mayoclinic.org/diseases-conditions/breast-cysts/symptoms-causes/syc-20370284
BI-RADS 2 is a benign category in breast imaging reporting and data system. A finding placed in this category should have a 100% chance of being benign.
And here is a more in depth article:
https://pmc.ncbi.nlm.nih.gov/articles/PMC10862574/
Another very in depth article:
https://www.ajronline.org/doi/pdf/10.2214/AJR.09.3688
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2 ReactionsI would insist on an MRI. Mammogram and even ultrasound can miss a suspicious cyst especially when it’s not palpable. Mine was palpable but the mammogram didn’t show it. With family history, you probably want to request genetic testing as well. It may be just a benign condition, but a benign MRI can put your mind at peace. Hugs.
Hi! I did a diagnostic ultrasound and she told me it had benign features so she gave me a birads 2 score. You think I should still push for a MRI?
Thank you! I was still worried seeing the words complex cyst . So with that score I shouldn’t worry?
It looks to me that mammogram didn’t identify the cysts but the ultrasound does and they showed benign on ultrasound. Maybe you need to ask the radiologist about the complex cysts. Cancer cysts are usually hypoechoic which means that they are solid mass. Hyperechoic is benign and probably cysts filled with liquid (they echo). I don’t have medical background, these are the things I learn during my cancer journey. I would still want to go for MRI as it’s a more reliable way to detect cancer early especially for dense breast. Either way, I recommend self breast exam monthly. That was how I found out about my cancer. Even when the cyst was palpable, my diagnostic mammogram was still benign. I went from ultrasound to needle biopsy to excisional biopsy. Thank God, it was detected early. Be an advocate for your health. If you worry about it, then push for an action for your peace of mind. Wish you all the best