Cyst containing internal echoes on US, thought to represent proteinaceous, fatty, or even cellular debris (e.g., blood or pus) but lacking any solid component
Not to be confused with complex cystic and solid mass
Complex features include any or all of following: Thick (≥ 0.5 mm) wall, thick septations, intracystic mass (e.g., mural nodule), mixed solid and cystic component(s)
Suspicious unless fatty mass on mammography &/or known to be due to trauma or surgery
If subsequently shown to be oil cyst on mammography, it should be so described
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
Image-Guided Biopsy
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
Jang JY et al: Clinical significance of interval changes in breast lesions initially categorized as probably benign on breast ultrasound. Medicine (Baltimore). 96(12):e6415, 2017
Kim SY et al: Application of the downgrade criteria to supplemental screening ultrasound for women with negative mammography but dense breasts. Medicine (Baltimore). 95(44):e5279, 2016
Berg WA et al: Quantitative maximum shear-wave stiffness of breast masses as a predictor of histopathologic severity. AJR Am J Roentgenol. 205(2):448-55, 2015
Berg WA et al: Technologist-performed handheld screening breast US imaging: how is it performed and what are the outcomes to date? Radiology. 272(1):12-27, 2014
Berg WA et al: Multiple bilateral circumscribed masses at screening breast US: Consider annual follow-up. Radiology. 268(3):673-83, 2013
Mendelson EB et al: Breast Imaging Reporting and Data System: BI-RADS, Ultrasound. 2nd ed. Reston: American College of Radiology, 2013
Berg WA et al: Cystic breast masses and the ACRIN 6666 experience. Radiol Clin North Am. 48(5):931-87, 2010
Daly CP et al: Complicated breast cysts on sonography: is aspiration necessary to exclude malignancy? Acad Radiol. 15(5):610-7, 2008
Chang YW et al: Sonographic differentiation of benign and malignant cystic lesions of the breast. J Ultrasound Med. 26(1):47-53, 2007
Berg WA et al: Operator dependence of physician-performed whole-breast US: lesion detection and characterization. Radiology. 241(2):355-65, 2006
Berg WA et al: Cystic lesions of the breast: sonographic-pathologic correlation. Radiology. 227(1):183-91, 2003
Szopinski KT et al: Tissue harmonic imaging: utility in breast sonography. J Ultrasound Med. 22(5):479-87; quiz 488- 9, 2003
Gizienski TA et al: Breast cyst recurrence after postaspiration injection of air. Breast J. 8(1):34-7, 2002
Kolb TM et al: Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. Radiology. 225(1):165-75, 2002
Buchberger W et al: Clinically and mammographically occult breast lesions: detection and classification with high-resolution sonography. Semin Ultrasound CT MR. 21(4):325-36, 2000
Hindle WH et al: Lack of utility in clinical practice of cytologic examination of nonbloody cyst fluid from palpable breast cysts. Am J Obstet Gynecol. 182(6):1300-5, 2000
Venta LA et al: Management of complex breast cysts. AJR Am J Roentgenol. 173(5):1331-6, 1999
Kolb TM et al: Occult cancer in women with dense breasts: detection with screening US--diagnostic yield and tumor characteristics. Radiology. 207(1):191-9, 1998
Bodian CA et al: The epidemiology of gross cystic disease of the breast confirmed by biopsy or by aspiration of cyst fluid. Cancer Detect Prev. 16(1):7-15, 1992
Ciatto S et al: The value of routine cytologic examination of breast cyst fluids. Acta Cytol. 31(3):301-4, 1987
Dixon JM et al: Natural history of cystic disease: the importance of cyst type. Br J Surg. 72(3):190-2, 1985
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Imaging
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
Proteinaceous cyst
Definitions
Cyst containing internal echoes on US, thought to represent proteinaceous, fatty, or even cellular debris (e.g., blood or pus) but lacking any solid component
Not to be confused with complex cystic and solid mass
Complex features include any or all of following: Thick (≥ 0.5 mm) wall, thick septations, intracystic mass (e.g., mural nodule), mixed solid and cystic component(s)
Suspicious unless fatty mass on mammography &/or known to be due to trauma or surgery
If subsequently shown to be oil cyst on mammography, it should be so described
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
Image-Guided Biopsy
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
Jang JY et al: Clinical significance of interval changes in breast lesions initially categorized as probably benign on breast ultrasound. Medicine (Baltimore). 96(12):e6415, 2017
Kim SY et al: Application of the downgrade criteria to supplemental screening ultrasound for women with negative mammography but dense breasts. Medicine (Baltimore). 95(44):e5279, 2016
Berg WA et al: Quantitative maximum shear-wave stiffness of breast masses as a predictor of histopathologic severity. AJR Am J Roentgenol. 205(2):448-55, 2015
Berg WA et al: Technologist-performed handheld screening breast US imaging: how is it performed and what are the outcomes to date? Radiology. 272(1):12-27, 2014
Berg WA et al: Multiple bilateral circumscribed masses at screening breast US: Consider annual follow-up. Radiology. 268(3):673-83, 2013
Mendelson EB et al: Breast Imaging Reporting and Data System: BI-RADS, Ultrasound. 2nd ed. Reston: American College of Radiology, 2013
Berg WA et al: Cystic breast masses and the ACRIN 6666 experience. Radiol Clin North Am. 48(5):931-87, 2010
Daly CP et al: Complicated breast cysts on sonography: is aspiration necessary to exclude malignancy? Acad Radiol. 15(5):610-7, 2008
Chang YW et al: Sonographic differentiation of benign and malignant cystic lesions of the breast. J Ultrasound Med. 26(1):47-53, 2007
Berg WA et al: Operator dependence of physician-performed whole-breast US: lesion detection and characterization. Radiology. 241(2):355-65, 2006
Berg WA et al: Cystic lesions of the breast: sonographic-pathologic correlation. Radiology. 227(1):183-91, 2003
Szopinski KT et al: Tissue harmonic imaging: utility in breast sonography. J Ultrasound Med. 22(5):479-87; quiz 488- 9, 2003
Gizienski TA et al: Breast cyst recurrence after postaspiration injection of air. Breast J. 8(1):34-7, 2002
Kolb TM et al: Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. Radiology. 225(1):165-75, 2002
Buchberger W et al: Clinically and mammographically occult breast lesions: detection and classification with high-resolution sonography. Semin Ultrasound CT MR. 21(4):325-36, 2000
Hindle WH et al: Lack of utility in clinical practice of cytologic examination of nonbloody cyst fluid from palpable breast cysts. Am J Obstet Gynecol. 182(6):1300-5, 2000
Venta LA et al: Management of complex breast cysts. AJR Am J Roentgenol. 173(5):1331-6, 1999
Kolb TM et al: Occult cancer in women with dense breasts: detection with screening US--diagnostic yield and tumor characteristics. Radiology. 207(1):191-9, 1998
Bodian CA et al: The epidemiology of gross cystic disease of the breast confirmed by biopsy or by aspiration of cyst fluid. Cancer Detect Prev. 16(1):7-15, 1992
Ciatto S et al: The value of routine cytologic examination of breast cyst fluids. Acta Cytol. 31(3):301-4, 1987
Dixon JM et al: Natural history of cystic disease: the importance of cyst type. Br J Surg. 72(3):190-2, 1985
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