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Found a complex cyst but no biopsy ordered ?

Posted by iza1989 @iza1989, Jan 22, 2025

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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yasamin | @yasamin | Dec 21, 2025
In reply to @lizziew "Hi ladies, New to this forum. I would love some feedback from anyone. From my reading..." + (show)
Profile picture for lizziew @lizziew

Hi ladies,

New to this forum.
I would love some feedback from anyone. From my reading and research, all signs point to benign Microcysts. Following is the report….
Mammo US breast limited left: Patient was scanned by sonographer and radiologist. Corresponding with the mammographic finding, there is a 6 mm x 3 mm x 6 mm oval, parallel-oriented, hypoechoic mass with circumscribed margins in the left breast at 9 o'clock, 3 cm from the nipple. Mass is nearly anechoic and may represent tiny clustered benign microcysts although technically indeterminate.

IMPRESSION:
Left
Left breast 6 mm mass at the 9 o'clock position. Definitive characterization is recommended with ultrasound-guided biopsy.
Benign cyst versus dilated focal duct within the nipple base. No definite intraductal mass identified.

BIRADS 4 Biopsy recommended.

Birds 4 is suspicious, but there is no letter attached to BIRADS, like A-C.

I have no family history of breast cancer in my very large family.
I do not want a needle core biopsy. I have read the horror stories, and I don’t want to go through that, when all signs point to a benign finding.
Doctors put you under for a colonoscopy, why don’t they do the same for breast biopsies? They are more invasive and more painful.

Thank you.

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@lizziew

Hi dear
First of all it has written the mass in your breast is oval while the bad ones are not oval they have irregular margins , second , Biobsy is not horrible , it’s not even painful I did it , but if you are really stressed about that you can ask the doctor to do an MRI it is also possible , but please follow that as soon as possible since B4 means urgent follow up .
I wish you health dear

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lizziew | @lizziew | Dec 22, 2025
In reply to @yasamin "@lizziew Hi dear First of all it has written the mass in your breast is oval..." + (show)
Profile picture for yasamin @yasamin

@lizziew

Hi dear
First of all it has written the mass in your breast is oval while the bad ones are not oval they have irregular margins , second , Biobsy is not horrible , it’s not even painful I did it , but if you are really stressed about that you can ask the doctor to do an MRI it is also possible , but please follow that as soon as possible since B4 means urgent follow up .
I wish you health dear

Jump to this post

@yasamin thank you.
I am very happy that your biopsy experience was not painful. You are a lucky one!
I know that I am being a big baby, but I am so nervous about undergoing one. My small breasts are more susceptible to pain, I have read.
I have a message in o my PCP to see if I can go on active surveillance for six months. Then, if another mammogram/ultrasound show any changes, I know I will have to submit to the biopsy.

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geet69 | @geet69 | Jan 2 12:08pm

My 2 cents about this- although I know it is a delayed response. In 2022 I was diagnosed with DCIS in my left breast. Had a mastectomy/reconstructive surgery. In 2024 I developed a red bump on my breast. Saw my breast surgeon, had an ultrasound. Determined it was a benign complex cyst. Six months later the bump was still there. My husband urged me to follow-up, so I went to my plastic surgeon. He took one look and said "I don't like the way that looks." Biopsy done. Cancer. Surgery, radiation and just finished chemo. My recommendation is to ask for a biopsy. I can't imagine where I would be if my husband had not been insistent!

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lansing | @lansing | Jan 3 10:12am
In reply to @roch "@iza1989 Welcome to Mayo Connect, for the most part, we are not medical professionals, instead we..." + (show)
Profile picture for Laurie, Volunteer Mentor @roch

@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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@roa second is generally paid by insurane if requested by you.ch

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