Simple Breast Cyst

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • The patient has a BIRADS 2 simple cyst:
    • To be regarded as a simple cyst, a mass must meet three criteria:
    • The margins must be circumscribed:
      • i.e., a margin “that is well defined or sharp, with an abrupt transition between the lesion and surrounding tissue”
    • It must be anechoic:
      • i.e., “without internal echoes”
    • It must show posterior acoustical enhancement:
      • i.e., “a column that is more echogenic deep to the mass”
  • Simple cysts are almost never associated with cancer in the absence of other abnormalities seen on mammogram or ultrasound
  • There are numerous reflectors in breast tissue:
    • All of the sound waves that are reflected do not make it back to the transducer:
      • Many of them bounce back and forth (reverberate) between reflectors in the tissue, and with each reverberation, part of the echoes return to the transducer, are recorded, and part undergo another excursion between the reflectors
    • Most of these echoes are obscured by all of the other echoes in the tissue, but when an otherwise anechoic window (a cyst) is present:
      • The reverberation echoes can be seen in the anterior part of the cyst:
        • In the image shown, a hyperechoic band can be seen within or just above the anterior wall of the cyst, especially on the left side of the image
      • The acoustic mismatches between this band and the less echogenic tissue superficial to it and the anechoic fluid deep to it, cause echoes that reverberate, creating the artifact in the near field of the cyst
  • References
    • D’Orsi CJ, Sickles EA, Mendelson EB, Morris EA. ACR BI-RADS® Atlas: Breast Imaging Reporting and Data System, 5th ed. Reston, VA: American College of Radiology; 2013.
    • Kremkau FW. Diagnostic Ultrasound: Principles and Instruments, 7th ed. Elsevier; 2006:274-292.
#Arrangoiz #BreastSurgeon #CancerSurgeon #SurgicalOncologist #BreastCancer #MountSinaiMedicalCenter #MSMC #Miami #Mexico
Unknown's avatar

Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

Leave a comment