Cyst Aspiration Turned Into Needle Core Biopsy

blaketots · December 2015

I'm a 41 years old and had a breast reduction 20 years ago. I felt pain in my left breast while eating Thanksgiving dinner. I thought the underwire in my bra was poking me and I adjusted my bra. It continued to hurt for a few days, so I felt around and discovered a lump. I searched the Internet and found out BC doesn't hurt and figured it was likely a cyst. Only, my period had just ended the same day I felt the pain and everything I read suggests that cysts get worse at the START of the menstrual cycle.

After a couple of days, I contacted my doctor who ordered a mammogram and ultrasound. I had not yet ever had a mammogram before since I am only 41 and have no breast cancer in my family or other risk factors. The radiologist told me it was a complicated cyst. Had all the tale-tale signs of a cyst, but had some internal echos. The radiologist said it likely had some debris floating around in it. He told me he saw several other cysts in my other breasts and reassured me it was quite normal to have cysts. He also told me I had mild asymmetries that were likely a result of my breast reduction and told me he wanted a follow-up mammogram in six months. He recommended a cyst aspiration to relieve the tenderness / pain and to confirm it was a cyst. He said there was no hurry to schedule it.

I scheduled the cyst aspiration for today. The cyst felt like it was smaller to the touch today than it was last week when I had the mammogram and ultrasound and I almost cancelled the appointment, but decided to keep it just to be safe. The radiologist had a very difficult time penetrating the cyst, because the tissue surrounding it was very thick as was the wall of the cyst. It was very painful even with the numbing medicine. After a very long time and many attempts, she pierced the cyst. She tried drawing fluid out, but none would come out. At that point, she told me they were converting to a needle core biopsy. They took 6 tissue samples and now I wait for 3 to 5 days for the results.

It was a surreal experience lying there on the table and having everything change so quickly. I was in a very uncomfortable position and my arm had gone numb from holding it above my head. It was just so hard to take it all in and have to deal with it all so suddenly.

The only symptoms I've had are the pain / tenderness in the lump/mass/cyst itself and a milk letdown feeling in my breasts from time to time very briefly. I last breastfed 12 years ago.

Moderators · December 2015

Blaketots-

The waiting game is truly one of the hardest parts. We're thinking of you, let us know when you hear back!

The Mods

blaketots · December 2015

My doctor's office said that my biopsy results were indicative of a ruptured cyst and inflammation with no cancer seen.

Good luck to everyone.

Jelson · December 2015

blakedots - I am sorry you had to go through this scary painful experience - but I am glad you acted on your instincts to pursue this and glad that it was found to be benign.

blaketots · December 2015

I got the official report from the radiologist after the biopsy.

She states:

Pathology results confirm a cyst wall with dense fibrosis and chronic inflammation consistent with a ruptured cyst and fibroadenomatoid changes. These findings are concordant with the imaging features. Ultrasound the left breast is recommended in 6 months.

BI-RADS Category 3: Probably benign - Interval follow-up suggested.

Before the biopsy, my BI-RADS was Category 4 Suspicious

I did a little research and it appears that fibroadenomatoid changes (FAC) is a potential risk factor for HER2-negative Invasive Breast Cancers.

Just when I thought the worry was over . . . . now I'm going to be nervous until my next diagnostic U/S in June.

Positive Association of Fibroadenomatoid Change with HER2-Negative Invasive Breast Cancer: A Co-Occurrence Study

Published: June 22, 2015 DOI: 10.1371/journal.pone.0129500

Abstract

Background

Risk assessment of a benign breast disease/lesion (BBD) for invasive breast cancer (IBC) is typically done through a longitudinal study. For an infrequently-reported BBD, the shortage of occurrence data alone is a limiting factor to conducting such a study. Here we present an approach based on co-occurrence analysis, to help address this issue. We focus on fibroadenomatoid change (FAC), an under-studied BBD, as our preliminary analysis has suggested its previously unknown significant co-occurrence with IBC.

Methods

A cohort of 1667 female patients enrolled in the Clinical Breast Care Project was identified. A single experienced breast pathologist reviewed all pathology slides for each case and recorded all observed lesions, including FAC. Fibroadenoma (FA) was studied for comparison since FAC had been speculated to be an immature FA. FA and Fibrocystic Changes (FCC) were used for method validation since they have been comprehensively studied. Six common IBC and BBD risk/protective factors were also studied. Co-occurrence analyses were performed using logistic regression models.

Results

Common risk/protective factors were associated with FA, FCC, and IBC in ways consistent with the literature in general, and they were associated with FAC, FA, and FCC in distinct patterns. Age was associated with FAC in a bell-shape curve so that middle-aged women were more likely to have FAC. We report for the first time that FAC is positively associated with IBC with odds ratio (OR) depending on BMI (OR = 6.78, 95%CI = 3.43-13.42 at BMI<25 kg/m²; OR = 2.13, 95%CI = 1.20-3.80 at BMI>25 kg/m²). This association is only significant with HER2-negative IBC subtypes.

Conclusions

We conclude that FAC is a candidate risk factor for HER2-negative IBCs, and it is a distinct disease from FA. Co-occurrence analysis can be used for initial assessment of the risk for IBC from a BBD, which is vital to the study of infrequently-reported BBDs.