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Old 04-25-2012
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Question Recurrent Breast Cyst Management

A 32-year-old woman has a 5-year history of tenderness in both breasts, related to menstrual cycle, with multiple lumps on both breasts that seem to "come and go" at different times in the menstrual cycle. She now has a firm, round, 3-cm mass that has not gone away for 6 weeks. As part of treatment plan, aspiration of cyts was done. Fluid aspirated was clear. Follow up examination 1 month later shows recurrence of the cyst. what is the next step in mx ?

1. cyst aspiration
2. reassurance
3. biopsy
4. antibiotic therapy
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Old 04-25-2012
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Biopsy (core biopsy to be more specific)
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Old 04-25-2012
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Fluid aspiration is clear so again cyst aspiration i think...if it was hemorrhagic or 3rd time reoccurrence than biopsy....
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Quote:
Originally Posted by confident View Post
Fluid aspiration is clear so again cyst aspiration i think...if it was hemorrhagic or 3rd time reoccurrence than biopsy....
What's your source?
my source is MTB 3

If she was over 40yrs then the answer would be mammography.

Last edited by Novobiocin; 04-25-2012 at 04:35 PM.
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Old 04-25-2012
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do biopsy.
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Quote:
Originally Posted by Novobiocin View Post
What's your source?
my source is MTB 3

If she was over 40yrs then the answer would be mammography.
My source is kaplan page 264...they say mass aspiration first and 4-6 weeks follow up that is 1 month as above case scenario if reappear then again aspiration as next step ....definitive step or therapy should be excisional biopsy right??....
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ans is biopsy.
cyst->aspiration->recurrence of cyst=suspected malignancy->biopsy to rule out cancer. make sense? it sounds okay to me...
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Quote:
Originally Posted by tyagee View Post
ans is biopsy.
cyst->aspiration->recurrence of cyst=suspected malignancy->biopsy to rule out cancer. make sense? it sounds okay to me...
But fluid aspirated was clear and mass completely collapsed.....so why we have to think malignency and biopsy?...
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But fluid aspirated was clear and mass completely collapsed.....so why we have to think malignency and biopsy?...
because it occured again. benign dont recur.:sorry::sorry:
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Old 04-26-2012
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Biopsy.. As the 1st intervention failed
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Breast cysts don't require treatment unless a cyst is large and painful or otherwise uncomfortable. In that case, draining the fluid from a breast cyst can ease your symptoms.[1]
Typical treatment involves a Needle aspiration biopsy. Aspirated cysts often recur (come back); definitive treatment may require surgery.
Draining the fluid and then waiting for the cyst to resolve it is the main treatment applied in these cases. Moreover, cysts that are aspirated and the fluid looks normal do not require any other medical attention apart from following-up to make sure it completely disappeared. Yet, hormone therapy by the means of oral contraceptives is sometimes prescribed to reduce their recurrence and to regulate the menstrual cycle of the patient (which is likely to cause them in the first place). Danazol may also be prescribed to treat this condition and it is usually considered in patients on whom the non-medical treatment fails and the symptoms are intense.
Surgical removal of a breast cyst is necessary only in a few unusual circumstances. If an uncomfortable breast cyst recurs month after month, or if a breast cyst contains blood-tinged fluid and displays other worrisome signs, surgery may be considered.

Source: http://en.wikipedia.org/wiki/Breast_cyst
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So what is the final summary for cyst management..first aspiration, fluid was clear and cyst completely collapsed -->follow up in 4 to 6weeks and if again reappear again aspiration ...if large size on third follow up, painful,or bloody discharge biopsy...any changes?
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Quote:
Originally Posted by confident View Post
So what is the final summary for cyst management..first aspiration, fluid was clear and cyst completely collapsed -->follow up in 4 to 6weeks and if again reappear again aspiration ...if large size on third follow up, painful,or bloody discharge biopsy...any changes?
I am going with biopsy if the cyst recurs on follow up. That is what MTB3 says.
However, Kaplan says you may aspirate again on follow up.
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