This document provides tips for using a PowerPoint presentation on breast cysts: 1. The PPT can be freely downloaded, edited, and modified. 2. Many slides are blank except for the title to facilitate active learning sessions where students provide information before each slide is shown. 3. The document recommends starting with blank slides, asking students what they know about the topic, and then showing the next slide with the relevant information. 4. This process should be repeated for three revisions to reinforce learning.

1. Tips on using my ppt.
1. You can freely download, edit, modify and put your
name etc.
2. Don’t be concerned about number of slides. Half the
slides are blanks except for the title.
3. First show the blank slides (eg. Aetiology ) > Ask
students what they already know about ethology of
today's topic. > Then show next slide which enumerates
aetiologies.
4. At the end rerun the show – show blank> ask questions >
show next slide.
5. This will be an ACTIVE LEARNING SESSION x
three revisions.
6. Good for self study also.
7. See notes for bibliography.

2. Introduction

3. Introduction
Clinical Presentation
• Breast lump-
• Needle aspiration should be part of physical
examination.
• Detected on screening
• Physical examination
• Mammography
• Sonomammography

4. Cysts on USG

5. Cysts on USG
• By ultrasound, cysts exist in up to one third
of women 35 to 50 years of age, with most
of these being nonpalpable.
• In women older than 60 years of age, cysts
are uncommon (5%), with half occurring in
women taking hormone replacement
therapy.

6. Breast cyst

7. Breast cyst
 Age group – 30-50
• Multiple and bilateral
• Can mimic malignancy
• Confirmed by USG and
aspiration

8. Etiology

9. Etiology
• Idiopathic
• Congenital
• Traumatic
• Infections /Infestation
• Autoimmune
• Neoplastic (Benign/Malignant)
• Degenerative

10. Classification

11. Classification
• Simple Cyst
• Complicated/Complex Cysts
– Galactocele
– Hematoma
– Fat necrosis or Oil cyst.
– Abscess.
– Intracystic Papilloma
– Necrotising carcinoma

12. Simple Cyst
• Most common masses seen at
mammography.
• Result from dilatation and effacement of the
Lacticeferous duct.
• Frequently multiple and fluctuate in size on
serial examinations.

13. Simple Cyst
Mammographic findings
• Circumscribed round or oval mass.
• Anechoic.
• Well circumscribed with a thin echogenic
capsule.
• Increased through-transmission.
• Thin edge shadows
• BI-RADS 2

14. BI-RADS system
Breast Imaging Reporting and Data System
Category Definition
0 Incomplete assessment; need additional imaging evaluation
1 Negative; routine mammogram in 1 year recommended
2 Benign finding; routine mammogram in 1 year recommended
3 Probably benign finding; short-term follow-up suggested
4 Suspicious abnormality; biopsy should be considered
5 Highly suggestive of malignancy; appropriate action should be taken

15. Simple Cyst
MRI
• Round, oval shape.
• Content : follow fluid signal on all
sequences and do not enhance.
• However, the periphery of the cyst may
enhance if there is surrounding pericystic
inflammation.

16. Breast cyst:Management

17. Breast cyst:Management
 Observation
 Aspirate
 Excision biopsy if-
Bloody aspiration
Residual mass
Suspicious cytology
Recurs

18. Complicated /Complex Cyst

19. Complicated /Complex Cyst
Cyst contains
• Intermal echoes
• Solid components
• fluid-fluid levels.

20. Complicated /Complex Cyst
– Galactocele
– Hematoma
– Fat necrosis or Oil cyst.
– Abscess.
– Intracystic Papilloma
– Necrotising carcinoma

21. Galactocele
• Relatively rare benign lesion.
• It is defined as a cystic enlargement of the
mammary gland containing milk.
• Galactocele of the breast is almost always
seen in young women in association with
lactation or some period after lactation.
• Clinically, the mass is usually firm, fairly
nontender and discrete, and often gives the
impression of a solid tumor.
• Caused by ductal obstruction.

22. Galactocele

23. Galactocele
• Clinically, the mass is usually firm, fairly
nontender and discrete, and often gives the
impression of a solid tumor
• A positive mucic acid test gives chemical
confirmation of the presence of milk.
• The gross pathologic picture is that of a
milk-filled cyst usually ranging in size from
1 to 6 cm. in diameter

24. Galactocele:Imaging
• The age of the milk products determines its
mam-mographic and sonographic
appearances.

25. Galactocele:Imaging
Mammographic images
• Typical - Circumscribed oval or round
mass.
• Late - Fat density layering on top.

26. Galactocele:Imaging
US
• Acute setting - a complicated cyst or
anechoic fluid with thin septa.
• The galactocele ages - increases in
complexity, fat–fluid levels.
• Milk curdles - solid components within the
cyst.
• Finally - a solid echogenic mass.

27. Galactocele
• Microscopically the picture is one of a
cystic space lined with flattened cuboidal
epithelium, adjacent pressure necrosis,
chronic inflammatory changes and often
active apocrine glands
• Treatment is simple excision

29. Get this ppt in mobile
1. Download Microsoft
PowerPoint from play
store.
2. Open Google assistant
3. Open Google lens.
4. Scan qr code from
next slide.

30. Get this ppt in mobile

31. Get my ppt collection
• https://www.slideshare.net/drpradeeppande/
edit_my_uploads
• https://www.dropbox.com/sh/x600md3cvj8
5woy/AACVMHuQtvHvl_K8ehc3ltkEa?dl
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• https://www.facebook.com/doctorpradeeppa
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