On a follow up visit the cyst was aspirated under ultrasound guidance. As a general rule, cyst aspiration is performed for symptomatic cases or in situations where ultrasound raises the question of a mural nodule. Over distension may result in rupture of the membrane and air within the breast parenchyma. CC and Lateral views are obtained to evaluate the air-filled cyst cavity for mural irregularities. Studies suggest that cytologic yield for malignancy is low for green or yellowish fluid and that only bloody aspirates should be routinely submitted for cytologic testing.
Surgical removal is warranted.
Thickening or irregularity of a cyst wall on mammography or sonography are suspicious findings for neoplasia. The American College of Radiology. 1993.