Will breast cysts become malignant at certain levels?

Breast cysts are generally benign lesions and usually do not become malignant, but if the cyst is accompanied by abnormal characteristics or other risk factors, the risk of malignant transformation may need to be paid attention to. In such cases, it is necessary to cooperate with the doctor for comprehensive assessment based on the grade of the cyst (such as BI-RADS grade) and individual health conditions, and take effective monitoring or treatment measures in a timely manner.

1) Breast cyst classification and risk

The grading of breast cysts is usually assessed according to the Breast Imaging Reporting and Data System (BI-RADS), which ranges from 0 to 6. Grade 0 means that more imaging examinations are needed, grades 1 and 2 are benign lesions with no risk of malignant transformation; grade 3 indicates a high probability of benignity, but follow-up observation is required; grade 4 is a moderate probability of malignancy, and fine needle aspiration biopsy is required to confirm the diagnosis; grades 5 and 6 usually indicate a high risk of malignancy or confirmed malignancy. The possibility of breast cysts becoming malignant usually occurs at grade 4 and above, so most cysts below grade 3 have basically no concerns about malignant transformation.

2) Risk factors for malignant transformation of breast cysts

The risk of malignant transformation may be related to a variety of factors, including genetic factors, fluctuations in hormone levels, environmental pollution, long-term stress, etc. For example, if there is a family history of breast cancer, or there are genetic factors such as BRCA1/BRCA2 gene mutations, you need to be vigilant. The size, shape, blood flow and state of the surrounding tissues of the cyst are also important bases for judging the possibility of malignant transformation. For example, if a breast cyst is accompanied by irregular edges, internal calcification, or abnormal blood flow signals, further examination is required.

3) How to monitor and treat breast cysts

(1) Regular physical examinations and imaging examinations: For grade 2 or 3 cysts without obvious symptoms, it is recommended to undergo breast ultrasound or mammography every 6-12 months to observe changes in the cyst. If the cyst does not change or shrinks, no special treatment is required.

(2) Drainage or pathological examination: For cysts that are large or painful to touch, ultrasound-guided fine needle aspiration can be used to drain the effusion or obtain pathological tissue. If cell abnormalities are found, further treatment is required.

(3) Minimally invasive surgery or other treatments: Cysts of grade 4 or above may require surgical removal, such as core needle biopsy or local excision. Minimally invasive methods such as endoscopy or cryotherapy may also be considered. The specific plan is decided by the doctor.

Breast cysts usually do not directly turn malignant, but you need to be alert to the accompanying high-risk characteristics and related risk factors. It is recommended to conduct self-examination and routine breast screening from time to time, find abnormalities early diagnosis and treatment, and maintain a healthy lifestyle, such as regular work and rest, a reasonable diet, and weight control to reduce the possibility of malignant transformation. Breast health requires long-term attention, and it is crucial to communicate with your doctor in time when problems are found.