From the Guidelines
Diagnosis and treatment of a breast oil cyst (also known as a galactocele or liponecrotic cyst) is typically conservative, with no need for biopsy or surgical intervention, as long as the mass is definitively characterized as benign on imaging.
Diagnosis
- The diagnosis of a breast oil cyst is usually made through imaging, with mammography or ultrasound (US) being the primary modalities used 1.
- On mammography, oil cysts typically appear as a benign mass with a characteristic appearance, such as a fat-containing lesion 1.
- Ultrasound can also be used to characterize the mass, and may show a simple cyst or a lipoma 1.
Treatment
- If the oil cyst is definitively characterized as benign on imaging, clinical follow-up is appropriate management, and imaging follow-up or tissue sampling is usually not indicated 1.
- No treatment is necessary for a breast oil cyst, as it is a benign condition.
- However, if the patient is experiencing symptoms such as pain or discomfort, aspiration or drainage of the cyst may be considered.
Imaging Follow-up
- Short-interval follow-up is not necessary for a definitively benign oil cyst 1.
- However, if the oil cyst is not definitively characterized as benign, or if there are any changes in the patient's symptoms or imaging findings, further evaluation and follow-up may be necessary 1.
From the Research
Diagnosis of Breast Oil Cyst
- The diagnosis of a breast oil cyst, also known as a galactocele or liponecrotic cyst, can be made using diagnostic mammogram, which demonstrates benign pathognomonic features of an oil cyst 2.
- Mammographic features of fat necrosis include radiolucent oil cyst, round opacity, asymmetrical opacity or heterogenicity of the subcutaneous tissues, dystrophic calcifications, clustered pleomorphic microcalcifications, and suspicious speculated mass 3.
- Ultrasound features of fat necrosis include solid, anechoic with posterior acoustic enhancement, anechoic with posterior acoustic shadowing, cystic with internal echoes, cystic with mural nodule, and increased echogenicity of the subcutaneous tissues 3.
Treatment of Breast Oil Cyst
- Simple cysts, including oil cysts, are not malignant and do not require intervention, but patients with symptomatic simple cysts can undergo elective aspiration, and typical cyst fluid can be discarded 4.
- Cysts with thick walls, thick septations, or solid components have a risk of malignancy and should undergo biopsy 4.
- Oil cysts can be a result of fat necrosis, which can be caused by trauma to the breast or fat grafting, and can lead to chronic inflammation and progressive calcification 5.
- In some cases, oil cysts can rupture, and clinicians should be aware of this potential complication when presented with the case of an expanding breast lump 2.