Distribution of Different Types of Cystic Breast Lesions and their Imaging Features: A Retrospective Observational Study

Introduction: Cystic disease of the breast is very common and present in women aged 35-50 years. They can be detected incidentally or present with lump, pain, or discharge. Confusion occurs in the appropriate classification and management of such cystic lesions. These lesions characteristically appear as circumscribed masses on mammography, but can be properly evaluated on ultrasound. Although the variable imaging features sometimes necessitate biopsy for confirmation of the diagnosis.

Aim: To estimate the prevalence of different types of cystic breast lesions and to study the imaging spectrum and features of cystic breast lesions.

Materials and Methods: This descriptive observational retrospective study was undertaken on all the women who presented for screening or diagnostic mammography and had ultrasonographically detected cystic component in the breast lesions. Based on the mammography and ultrasonographic features, cystic lesions were classified and final Breast Imaging Reporting and Data System (BI-RADS) category was assigned. Fine Needle Aspiration Cytology (FNAC) or biopsy was performed whenever required. The values were represented in number and percentage.

Results: Out of 836 women who had undergone mammography and Ultrasonography (USG), 134 patients were diagnosed with cystic breast lesions. Simple cyst with or without fine septa was most common type of cystic lesion present in 53 (39.6%) cases. It was followed by complex solid cystic lesion seen in 36 (26.8%) cases, complicated cyst 30 (22.4%) and complex cyst with thickened wall or septa in 15 (11.2%) cases.

Conclusion: Cystic breast lesions are common entities with variable and overlapping imaging characteristics, based on which they can be categorised as BI-RADS 2 to BI-RADS 5 lesions.