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Breast
Procedures
Image-Guided Procedures
Cyst Aspiration
Cyst Aspiration
Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS

  • Preprocedure

    • Procedure

      • Outcomes

        TERMINOLOGY

        • Definitions

          • Percutaneous aspiration of fluid from breast cyst
            • Most efficiently performed with real-time US guidance, usually by radiologist
            • Can be performed by clinician using palpation
          • BI-RADS 2 when aspiration recommended for symptomatic relief and lesion clearly simple cyst
          • BI-RADS 4A when aspiration performed for diagnostic uncertainty
            • Small lesion, usually ≤ 8 mm
            • Low-level internal echoes, possibly solid

        PREPROCEDURE

        • Indications

          • Contraindications

            • Getting Started

              PROCEDURE

              • Patient Position/Location

                • Equipment Preparation

                  • Procedure Steps

                    • Findings and Reporting

                      • Alternative Procedures/Therapies

                        POST PROCEDURE

                        • Expected Outcome

                          OUTCOMES

                          • Complications

                            Selected References

                            1. Berg WA et al: Cystic breast masses and the ACRIN 6666 experience. Radiol Clin North Am. 48(5):931-87, 2010
                            2. Daly CP et al: Complicated breast cysts on sonography: is aspiration necessary to exclude malignancy? Acad Radiol. 15(5):610-7, 2008
                            3. Berg WA et al: Operator dependence of physician-performed whole-breast US: lesion detection and characterization. Radiology. 241(2):355-65, 2006
                            4. Bassett LW et al: Diagnosis of Diseases of the Breast. 2nd ed. Philadelphia: Elsevier Saunders. 323-8, 2005
                            5. Stavros AT: Breast Ultrasound. Philadelphia: Lippincott Williams and Wilkins. 742-8, 2004
                            6. Gizienski TA et al: Breast cyst recurrence after postaspiration injection of air. Breast J. 8(1):34-7, 2002
                            7. Buchberger W et al: Incidental findings on sonography of the breast: clinical significance and diagnostic workup. AJR Am J Roentgenol. 173(4):921-7, 1999
                            8. Venta LA et al: Management of complex breast cysts. AJR Am J Roentgenol. 173(5):1331-6, 1999
                            9. Smith DN et al: Impalpable breast cysts: utility of cytologic examination of fluid obtained with radiologically guided aspiration. Radiology. 204(1):149-51, 1997
                            10. Ikeda DM et al: The role of fine-needle aspiration and pneumocystography in the treatment of impalpable breast cysts. AJR Am J Roentgenol. 158(6):1239-41, 1992
                            11. Ciatto S et al: The value of routine cytologic examination of breast cyst fluids. Acta Cytol. 31(3):301-4, 1987
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Preprocedure

                              • Procedure

                                • Outcomes

                                  TERMINOLOGY

                                  • Definitions

                                    • Percutaneous aspiration of fluid from breast cyst
                                      • Most efficiently performed with real-time US guidance, usually by radiologist
                                      • Can be performed by clinician using palpation
                                    • BI-RADS 2 when aspiration recommended for symptomatic relief and lesion clearly simple cyst
                                    • BI-RADS 4A when aspiration performed for diagnostic uncertainty
                                      • Small lesion, usually ≤ 8 mm
                                      • Low-level internal echoes, possibly solid

                                  PREPROCEDURE

                                  • Indications

                                    • Contraindications

                                      • Getting Started

                                        PROCEDURE

                                        • Patient Position/Location

                                          • Equipment Preparation

                                            • Procedure Steps

                                              • Findings and Reporting

                                                • Alternative Procedures/Therapies

                                                  POST PROCEDURE

                                                  • Expected Outcome

                                                    OUTCOMES

                                                    • Complications

                                                      Selected References

                                                      1. Berg WA et al: Cystic breast masses and the ACRIN 6666 experience. Radiol Clin North Am. 48(5):931-87, 2010
                                                      2. Daly CP et al: Complicated breast cysts on sonography: is aspiration necessary to exclude malignancy? Acad Radiol. 15(5):610-7, 2008
                                                      3. Berg WA et al: Operator dependence of physician-performed whole-breast US: lesion detection and characterization. Radiology. 241(2):355-65, 2006
                                                      4. Bassett LW et al: Diagnosis of Diseases of the Breast. 2nd ed. Philadelphia: Elsevier Saunders. 323-8, 2005
                                                      5. Stavros AT: Breast Ultrasound. Philadelphia: Lippincott Williams and Wilkins. 742-8, 2004
                                                      6. Gizienski TA et al: Breast cyst recurrence after postaspiration injection of air. Breast J. 8(1):34-7, 2002
                                                      7. Buchberger W et al: Incidental findings on sonography of the breast: clinical significance and diagnostic workup. AJR Am J Roentgenol. 173(4):921-7, 1999
                                                      8. Venta LA et al: Management of complex breast cysts. AJR Am J Roentgenol. 173(5):1331-6, 1999
                                                      9. Smith DN et al: Impalpable breast cysts: utility of cytologic examination of fluid obtained with radiologically guided aspiration. Radiology. 204(1):149-51, 1997
                                                      10. Ikeda DM et al: The role of fine-needle aspiration and pneumocystography in the treatment of impalpable breast cysts. AJR Am J Roentgenol. 158(6):1239-41, 1992
                                                      11. Ciatto S et al: The value of routine cytologic examination of breast cyst fluids. Acta Cytol. 31(3):301-4, 1987