Virginia Commonwealth University Breast Imaging

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Cyst Aspiration

Cysts are very common. Although they cannot be accurately diagnosed with physical examination or mammography alone, they can usually be diagnosed accurately with ultrasound. In most women, they do not usually require any intervention or follow-up.

Cyst aspirations are done when a cyst is causing significant tenderness or when the diagnosis of a cyst remains in question following the ultrasound.

About the Procedure

For a cyst aspiration, you usually lie on your back or slightly turned to one side with your arm placed comfortably under your head.

The skin is cleaned with betadine and alcohol and then numbed with topical anesthesia (1 percent lidocaine). Using ultrasound guidance, a small needle is advanced into the cyst and suction is applied to draw the fluid out, causing the lump to collapse.

The aspirated fluid may be discarded or, if bloody, sent for evaluation. Following aspiration, cysts may recur.

If breast cancer is suspected following a diagnostic mammogram, ultrasound or MRI, we may recommend one of the following procedures to establish an exact diagnosis:

A possible cyst in the patient’s breast.

The lump (arrow) in this patient’s right breast was thought to be a cyst, but some features are not characteristic and aspiration was necessary. Although cyst aspiration is not indicated in most patients, if the diagnosis remains in question, or if the cyst is causing symptoms, an aspiration can be done.

A cyst aspiration.

Using ultrasound guidance, a fine needle (white line) is placed so that its tip (double arrow) is in the center of the lump (single arrow). Aspiration is applied by using a syringe attached to the needle. If this is a cyst, fluid is drawn into the syringe as the lesion collapses.

The breast after the aspiration.

After the aspiration, the needle (white line) and its tip (double arrow) are seen, but the lump is gone.

Virginia Commonwealth University Medical Center VCU Breast Imaging