Found a complex cyst but no biopsy ordered ?

Posted by iza1989 @iza1989, Jan 22 8:35pm

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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@myoga

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

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Thank you for responding ! Glad they caught it early for you too.
As far as what the radiologist said he said “debris in cyst” but everything looks benign. So im not sure

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@iza1989

Thank you for responding ! Glad they caught it early for you too.
As far as what the radiologist said he said “debris in cyst” but everything looks benign. So im not sure

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According to one of the articles cited by meeshodge, a complex cyst should be BI-RADS 4 and biopsy is recommended.

“Because complex cysts are associated with varying incidences of malignancy, they were assigned BIRADS categories 4 or 5 and biopsy was recommended.”

Now I’m confused! Maybe you can show him the article and ask for clarification. Ask questions until you’re satisfied with the answer. Some doctors are irritated when you ask lots of questions, but it’s your health and you pay them. If you can, go for 2nd opinion.

A complex cyst can still be benign (also according to the article)

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@myoga

According to one of the articles cited by meeshodge, a complex cyst should be BI-RADS 4 and biopsy is recommended.

“Because complex cysts are associated with varying incidences of malignancy, they were assigned BIRADS categories 4 or 5 and biopsy was recommended.”

Now I’m confused! Maybe you can show him the article and ask for clarification. Ask questions until you’re satisfied with the answer. Some doctors are irritated when you ask lots of questions, but it’s your health and you pay them. If you can, go for 2nd opinion.

A complex cyst can still be benign (also according to the article)

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My problem is I read too much into details and sometimes it scares the hell out of me. Like I said before, I don’t have medical training. These are just my own opinions and they may be wrong.

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@myoga

According to one of the articles cited by meeshodge, a complex cyst should be BI-RADS 4 and biopsy is recommended.

“Because complex cysts are associated with varying incidences of malignancy, they were assigned BIRADS categories 4 or 5 and biopsy was recommended.”

Now I’m confused! Maybe you can show him the article and ask for clarification. Ask questions until you’re satisfied with the answer. Some doctors are irritated when you ask lots of questions, but it’s your health and you pay them. If you can, go for 2nd opinion.

A complex cyst can still be benign (also according to the article)

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I think if it has malignant features it should be rated birad 3,4,5 and biopsies is my understanding

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@myoga

My problem is I read too much into details and sometimes it scares the hell out of me. Like I said before, I don’t have medical training. These are just my own opinions and they may be wrong.

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I just used chatGPT and this is what it said

The term "complex cyst" refers to a cyst that has both fluid and solid components, or internal structures like septations (dividers inside the cyst). While a complex cyst might seem more concerning at first, the BI-RADS 2 score indicates that the overall risk for cancer is extremely low, suggesting that the cyst is benign.

The BI-RADS system is used to classify breast imaging findings based on their appearance and likelihood of being cancerous. A BI-RADS 2 score specifically means that the abnormality is benign—no malignancy is suspected. So, even though the cyst is complex (which can sometimes raise concerns), it doesn't have features that would typically point to cancer, such as irregular shape, spiculated borders, or solid areas with suspicious characteristics.

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@iza1989

I just used chatGPT and this is what it said

The term "complex cyst" refers to a cyst that has both fluid and solid components, or internal structures like septations (dividers inside the cyst). While a complex cyst might seem more concerning at first, the BI-RADS 2 score indicates that the overall risk for cancer is extremely low, suggesting that the cyst is benign.

The BI-RADS system is used to classify breast imaging findings based on their appearance and likelihood of being cancerous. A BI-RADS 2 score specifically means that the abnormality is benign—no malignancy is suspected. So, even though the cyst is complex (which can sometimes raise concerns), it doesn't have features that would typically point to cancer, such as irregular shape, spiculated borders, or solid areas with suspicious characteristics.

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That sounds good. I hope you are comfortable with the explanation of the complex cyst now. Just make sure you do self breast exam monthly. 💕

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@myoga

That sounds good. I hope you are comfortable with the explanation of the complex cyst now. Just make sure you do self breast exam monthly. 💕

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I think so! I was more fixated on the term complex cyst than the benign part. All of this is scary ): wish I could just do the surgery

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@iza1989

I think so! I was more fixated on the term complex cyst than the benign part. All of this is scary ): wish I could just do the surgery

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I don’t wanna always have to worry

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