The validity of complex breast cysts after surgery

1. Objective:

Breast cysts are the most common cause of benign breast masses.

Simple breast cysts do not need further evaluation, but complex breast cysts require additional assessment due to the potential presence of malignancy. However these complex cysts have rarely been examined and quantified according the associated cancer detection rate. Our study is the first investigation that evaluates the malignancy rate of complex breast cysts identified by histopathological results.

2. Methods:

Imaging findings of complex cysts were correlated retrospectively with clinical and pathologic outcomes.

3. Results:

151 complex breast cysts were found in 131 women. We detected a high malignancy rate of 13.9%. Sonographic criteria of a complex cyst such as thick cyst wall (p=0.0006), lobulation (p=0.01) or hyperechogenicity (p=0.04) were predictive of neoplasm. Two or more criteria combined were associated with a 13.6– fold higher risk of malignancy (p<0.0001). Menopause status, family history or personal history of breast cancer did not influence the detection rate of neoplasm.

4. Conclusion:

Based on our results we raise the issue for the need of surgical intervention, compared to observation by ultrasound of complex breast cysts to prevent a missed or delayed diagnosis of breast cancer.