HIGH RISK BREAST DISORDERS:

Complex Cysts

Defined as cysts with thick walls, thick septa, intracystic masses, or other discrete solid components; There are many subtypes covering a wide range of benign and pathologic diagnoses

Subsequent breast cancer risk: < 1% to 23%                                                                        

Imaging:

–     US: Thick walls or thick septa (> 0.5mm); Intracystic masses or other discrete solid components

–     Mammogram: Like simple cysts: uniformly dense (discoid w/compression), round/ovoid shape, circumscribed margins

Management: Biopsy to rule out malignancy - surgical excision if pathology discordant, atypical, or indeterminate; Higher risk of malignancy with thicker walls, thicker septa, more solid components

(Doshi 2007, Ikeda 2010, Georgian-Smith 2014, Sabel 2015)