Breast Cysts and Calcifications

The signs and symptoms of breast cysts vary from person to person, but they may include:

• A lump in the breast tissue that is usually round or oval and has distinct, smooth edges
• Nipple discharge that can be clear, yellow, gold, or brown
• Breast pain or tenderness around the cyst(s)
• Increase in the size of the cyst(s) just before the beginning of your period and a decrease in size (and any related discomfort) after your period

There are two general types of breast cysts – simple and complex.

Simple cysts

Contain only clear fluid. These are almost always benign (non-cancerous), and they make up about 95 percent of all cysts seen on a screening mammogram.

Complex cysts

Contain debris, like blood or other matter, and they should most often be evaluated by a breast biopsy.

Experts don’t know what causes cysts to form in the breasts. There is evidence that excess estrogen in the body may be a contributing factor. Breast cysts develop when fluid accumulates inside the glands in the breasts.

There are two basic classifications of breast cysts, related to their size: microcysts and macrocysts. Microcysts are too tiny to be felt, but they may be visible during imaging tests, like mammography or ultrasound. Macrocysts can be felt by touching the affected area of the breast. They can grow as large as one to two inches in diameter. When breast cysts are large, they can put pressure on adjacent breast tissue, which can cause discomfort and pain.

If you feel any new breast lumps and they do not go away after your period ends, call your doctor right away. While most breast cysts are usually not cancerous, it’s always a good idea to have any lump or cyst checked out by your doctor.

There are two general classifications of breast calcifications – macrocalcifications and microcalcifications.

Macrocalcifications

Macrocalcifications appear as large white spots that look like dashes or dots. They are rarely cancerous, and their presence does not require additional testing or follow up other than routine care.

Microcalcifications

Microcalcifications appear as tiny white specks. They are also usually noncancerous, but if these tiny specks form certain patterns, they can indicate cancer or a precancerous condition.

If your mammogram shows microcalcifications that appear questionable, your doctor may recommend a second mammogram to take additional views and get a closer look. If your doctor is still concerned after the second mammogram, he or she will likely recommend a breast biopsy to evaluate the calcifications and surrounding tissue.

There are many conditions that can cause breast calcifications, including:

• Breast cancer
• Ductal carcinoma in situ (DCIS)
• Mammary duct ectasia
• Cell secretions
• Fibroadenoma
• Injury or trauma to breast tissue, including breast surgery
• Previous radiation therapy
• Calcification of the skin or blood vessels

If you use skin products that contain certain materials that are considered “radiopaque,” the radiopaque particles can look like calcifications on a mammogram. For that reason, you should not wear any deodorant or skin products before your mammogram.

Since you cannot feel breast calcifications or see them without the aid of mammography, your doctor will likely be the one reporting the presence of calcifications to you. If your doctor believes the calcifications could be a sign of cancer or ductal carcinoma in situ, he or she will follow up with you to talk about next steps.

The most important thing you can do to ensure that any breast calcifications are found and, if necessary, tested is to always get your recommended mammograms. Talk to your doctor about the mammography guidelines that apply to you.

Many women who have fibrocystic breasts don’t experience any pain or symptoms, but some women do report breast pain or tenderness and areas of lumpy tissue in the upper area of the breast and on the sides near the underarms. These symptoms, if experienced, tend to occur more just before menstruation. Signs and symptoms of fibrocystic breasts can include:

• Noticeable areas of thicker tissue
• Breast pain or tenderness
• Breast lumps that tend to grow and shrink throughout the menstrual cycle
• Breast changes that seem to occur similarly in both breasts
• An increase in signs and symptoms from ovulation to just before menstruation (about two weeks out of the month)

Experts aren’t sure what causes these changes, but they believe it’s due to hormones like estrogen.

While the changes associated with fibrocystic breasts are normal, there is some overlap in symptoms between fibrocystic breast changes and breast cancer. If you notice any of the following signs or symptoms, make an appointment to see your doctor.

• You detect a new breast lump or an area of thickening that seems prominent
• Your breast pain is continuous or worsening
• The changes in your breasts continue after your period begins
• A previous lump that was evaluated and thought to be normal has changed in shape or size
• You experience nipple discharge that can be dark brown or green and may leak spontaneously without any pressure or squeezing applied to your breasts

If you are ever worried about a breast lump, breast pain or tenderness, or any other breast symptoms, don’t hesitate to call your doctor or make an appointment.