Complicated Cyst

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Tiger98
Tiger98 Member Posts: 186
edited January 2022 in Not Diagnosed But Worried

I am starting a new post since I have a new issue. So I went back to get my focal asymmetry looked at (6 months look) and they told me it was good news, that I just had a cyst and they would see me in 6 months. The prior thought was that the asymmetry was scar tissue from my implants. Ultrasound was negative first time. I did not speak to the radiologist this time. I went on my way!

When I got the report, it says the asymmetry I had 6 months ago in the inner lower breast is no longer visible. It said I now have a round asymmetry at 5:00 in the retroareolar area MLO view per mammogram...so this was actually a new finding? I guess what confuses me was that the focal asymmetry from the first round was described at 5:00, 2 cm from nipple, and this one says 5:00 retroareolar? So are these two different things? I wish I had the opportunity to hear the details and ask questions.

It says there is a small, avascular, hypoechoic mass measuring 2mm x 1mm x 2mm. It says "its nonspecific but seems to correlate with the round asymmetry on the mammogram and likely represents a small, complicated cyst". It was given a BIRADS-3 and 6 month follow up. How do they know for sure it is a cyst and not a more worrisome mass..I am assuming they can see fluid even when it is this small?

I can post both reports if that helps. I guess I am just confused!

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  • Beesie
    Beesie Member Posts: 12,240
    edited May 2021

    It would be easier for others to try to help you figure out if this is new and different if you'd posted this in the same thread as your previous information.

    That said, I don't know that it matters whether this is in the same area or not. If it's in the same area, then it provides an explanation for the asymmetry, which is good. If the asymmetry is gone, that is good.

    Complicated cysts are common and generally easy to identify on ultrasound imaging. They are similar to simple cysts in that they are fluid-filled (which shows up on ultrasounds but not on mammograms). Simple cysts are perfectly symmetrical, fully fluid-filled and evenly round or oval. Any cyst that doesn't perfectly match that description will be classified as a complicated cyst (unless it's a complex cyst, which can be quite different and may be more concerning). So complicated cysts may not be perfectly round or oval, or the borders might be slightly uneven, or they might contain little bits of solid debris.

    As in your case, the standard assessment for a complicated cyst is a BI-RADS3, with the follow-up being repeat imaging in 6 months. The radiologist will be looking for either stability or shrinkage. I've had complicated cysts and never had any problems with them - eventually they shrunk and disappeared on their own. Your complicated cyst, at 2mm x 1mm x 2mm, is tiny tiny tiny.

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  • Tiger98
    Tiger98 Member Posts: 186
    edited May 2021

    Thank you Beesie, I wasn't sure what to do. I appreciate the info! Do you suggest I ask any further questions or should I just wait out the 6 months? I was really hoping to be given the all clear so I could move on. Do complicated cysts feel different?

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  • Beesie
    Beesie Member Posts: 12,240
    edited May 2021

    I can try to help interpret the words in your report, and I can explain what a complicated cyst is and why a specific next step has been recommended, but I can't tell what you should do.

    Do complicated cysts feel different? Different from what? Your complicated cyst is 1/3rd the size of a grain of rice - can you feel it?


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  • Tiger98
    Tiger98 Member Posts: 186
    edited May 2021

    I actually feel that I can! I am a thin person and have very little breast tissue and what I do have is pushed out by my implants. The ultrasound tech told me my breast tissue was the same thickness is my actual skin!


    I guess what would make me feel better is knowing how accurate ultrasound is in assessing a cyst/mass the size of what mine showed up as, in terms of showing that it is indeed truly a cyst. Is it too small to know? I am trying to just go with her suggestion of a six month watch and wait and try not to worry. Also is the fact that it is round a bad thing vs it being oval? I am wondering if I can ask if this can just be biopsied or aspirated just for peace of mind. My doctor is retiring so I suppose I need to get with someone new to help me with this. I am worrying a lot!

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  • Tiger98
    Tiger98 Member Posts: 186
    edited May 2021

    Just wondering if anyone has any insight on the above questions. My GYN didn't respond to my messagea week ago, he is retiring so I guess he doesn't care! I am establishing with someone else but I can't get in for 5 weeks.

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  • Tiger98
    Tiger98 Member Posts: 186
    edited January 2022

    I am going back in on Friday for the 6 month look at this (although it is longer than 6 months due to scheduling). I am very nervous!!

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  • Tiger98
    Tiger98 Member Posts: 186
    edited January 2022

    Well since I have been exposed to COVID, they had to push my appointment back a week...

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  • Tiger98
    Tiger98 Member Posts: 186
    edited January 2022

    I know my thread is pretty quiet but I wanted to update in case anyone is following, or is searching terms.

    So I went back today to follow up on my BIRADS-3 from last May. Due to COVID exposure and a different health issue, it was 8 months between appointments. My left breast was due for a regular mammogram and follow up on my right. So they mammogrammed both sides. After waiting awhile the tech came in with a list of spots to ultrasound on the right. Left was clear again. It’s funny bc my left one is the one that’s more fibrocystic and sore. So the areas of concern on the right at 500-600 showed up again and a new spot at 11:30. 11:30 showed a simple cyst on ultrasound. The complicated cyst at 5:30 couldn’t be seen this time, but the tissue in that areA just looks different than the left, but it hasn’t changed since my first mammogram in Oct 2020.

    After some discussion with the radiologist, she came back in. She said the radiologist remembers my case as it’s unique. I have areola incision implants that I have had for 12 years. The spots that keep showing up as asymmetries, are almost exactly where my incisions are. They are right on the border of my areola. She said they almost never see implants done in this way, and they were intrigued as to why I had them done that way. I’m happy to share why of anyone is interested. The Radiologist said in her career she has seen a few other cases like this, but she consulted with others to confirm her thoughts. Since this area has shown stability, I have had surgery there, and a negative ultrasound and manual exam, they are putting me back on a regular screening. She did say though that I will need a diagnostic every time Instead of just regular screening since my oberqlltissue is so dense. I didn’t even know that was an option but I’m glad there is. In hindsight, I wish i had known my type of implant could affect a mammogram screening! I appreciate the support I have received and hope my story can help others.

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