Tests and diagnosis

By Mayo Clinic Staff

Screening and diagnosis of a breast cyst usually begins after you or your doctor identify a breast lump. In addition to discussing your symptoms and health history, your doctor will do a breast exam and may do a breast ultrasound or fine-needle aspiration, depending on your needs.

Breast exam

Your doctor will physically examine the breast lump and check for any other problem areas in your breasts. Because your doctor can't tell from a clinical breast exam alone whether a breast lump is a cyst, you'll need another test, either an imaging test or fine-needle aspiration.

Breast ultrasound

Breast ultrasound can help your doctor determine whether a breast lump is fluid-filled or solid. A fluid-filled area usually indicates a breast cyst. A solid-appearing mass most likely is a noncancerous lump, such as a fibroadenoma, but solid lumps also could be breast cancer.

Based on what the doctor sees on the ultrasound, he or she might recommend a biopsy to further evaluate a solid-appearing mass. If your doctor can easily feel a breast lump, he or she may skip breast ultrasound and perform fine-needle aspiration instead.

Fine-needle aspiration

During a fine-needle aspiration, your doctor inserts a thin needle into the breast lump and attempts to withdraw (aspirate) fluid. Often, fine-needle aspiration is done using ultrasound to guide accurate placement of the needle. If fluid comes out and the breast lump goes away, your doctor can make a breast cyst diagnosis immediately.

  • If the fluid is not bloody and the breast lump disappears, you need no further testing or treatment.
  • If the fluid appears bloody or the breast lump doesn't disappear, your doctor may send a sample of the fluid for lab testing and refer you to a breast surgeon or to a radiologist — a doctor trained to perform imaging exams and procedures — for follow-up.
  • If no fluid is withdrawn, your doctor will likely recommend an imaging test, such as mammography or ultrasound, to further evaluate the lump. Lack of fluid or a breast lump that doesn't disappear after aspiration suggests that the breast lump — or at least a portion of it — is solid, and a sample of cells may be collected and sent for analysis to check for cancer (fine-needle aspiration biopsy).
Nov. 09, 2012