Repeated aspiration of breast cysts—a safe procedure

Abstract

We have made a retrospective study of 197 patients who underwent 367 breast cyst aspirations and in whom the fluid obtained was sent for cytological examination between January 1974 and August 1976. Four specimens were reported as showing malignant cells in the aspirate. All of these were excised and 3 were confirmed to be malignant. A further 8 showed bizarre or atypical appearances, of which four were excised and 1 was malignant. The other 4 were subjected to repeat aspiration, at which time typical benign appearances were reported and no further action taken. No tumour developed in the follow-up period of at least 2 years. Of the patients whose initial cytology was benign, 51 were subjected to repeated aspiration of clinically recurrent cysts, 28 on 3 or more occasions. Ten patients underwent excision biopsy of histologically benign lesions. None of these 51 patients developed a malignant tumour at the site of the cyst in the 2-year follow-up period.

Benign breast disease: The cost of the service and the cost to the patient

“…It still surprises me that many clinicians, in many parts of the world, adhere to the obsolete notion that cyst aspiration is a hazardous procedure on the basis that an intracystic cancer might be missed and, also, that a solid tumor, if punctured, might disseminate the cancer. A number of publications have demonstrated the safety of this policy [8,9]. Furthermore, my own experience has suggested that mammograms performed following cyst aspiration were not only unhelpful but positively misleading [10].…”