II. Epidemiology

  1. Breast cysts are most common in ages 35 to 50 years

III. Indications

  1. Palpable Breast Mass which appears cystic

IV. Technique

  1. Use skin marker to mark center of lesion
  2. Prepare Breast skin with betadine or hibiclens
  3. Drape Breast
  4. Immobilize lesion between index and middle finger
  5. Aspirate lesion 21-25 gauge needle and 5 cc syringe
    1. Draw back on syringe plunger while inserting
    2. Withdraw and redirect if no fluid aspirated
  6. Apply local pressure to aspiration site
  7. Apply Bacitracin and bandage to entry site

V. Complications

  1. Pneuomothorax
    1. Prevent by positioning lesion over a rib
  2. Hematoma
    1. Prevent by applying local pressure after aspiration

VI. Safety

  1. Does not affect MammographySpecificity
    1. However mammographer should be aware of aspiration
  2. Aspiration does not increase cancer risk

VII. Interpretation

  1. No fluid (failed aspiration)
    1. Consider breast Ultrasound to better localize
    2. Refer solid lesions for Breast biopsy
  2. Bloody Fluid Aspirate
    1. Do NOT drain cyst (discontinue aspiration!)
    2. Send fluid for Cytology
    3. Refer to Surgery for fine needle aspirate
  3. Non-bloody fluid aspirate
    1. Drain cyst completely
    2. Discard aspirate fluid
    3. Reexamine after draining cyst
      1. Refer to surgery if mass still present
    4. Repeat Breast Exam in 4-6 weeks

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