Study Finds Breast Cysts Signal Increased Cancer Risk

By Suzanne Leigh, Medical Tribune News Service

The breast-cancer risk of women younger than 45 who have breast cysts may be six times that of the general population. In a study published Friday in the British journal The Lancet, researchers from the Edinburgh Breast Unit at Western General Hospital in Scotland followed 1,374 women diagnosed with palpable cysts -- cysts that are large enough to be felt -- for an average period of about nine years.

Lead researcher J. Michael Dixon reported that 65 cancers developed during follow-up. When this figure was compared to the general population of Scottish women, the researchers found that the overall risk for participants in the breast-cyst group was nearly three times higher. When they looked at women under 45 in the breast-cyst group, they found their risk was amplified to 5.9 times that of the general population. In contrast, the breast-cancer risk for 55-year-old women with breast cysts was 1.7 times that of the general population.

Breast cysts occur in about 7 percent of women in developed counties. According to the Mayo Clinic of Rochester, Minn., breast cysts are fluid-filled sacs in the breast tissue that typically occur in women ages 35 to 50. They may be treated by draining the fluid under local anesthesia and removing a sample of tissue for laboratory analysis. While several examples of earlier research found no association between breast cysts and cancer, at least six newer reports have determined that these results were flawed.

In the United Kingdom, the National Health Service Breast Screening Programme recommends that women older than 50 should have mammography, an x-ray of the breast to scan for potentially cancerous tissue, once every three years. Given the increased risk faced by women under 45 with breast cysts, mammography should be a consideration for ``an age group in which breast screening is not generally available,'' Dixon said. In the United States mammography is usually recommended for women annually beginning at age 40. Breast cancer is more prevalent in the United States, striking one woman in nine, versus one in 12 in the United Kingdom, according to government figures.

Older women are at greater risk of breast cancer than younger women. According to statistics from the Brigham and Women's Hospital in Boston, one in 200 women is diagnosed with breast cancer by age 40, and one in 50 women is diagnosed with breast cancer by age 50. Dr. Theodore Lo of the department of radiation oncology at the Lahey Clinic in Burlington, Mass., said that his patient data provide no evidence that women with breast cysts face an increased risk of developing cancer. ``I am surprised by the findings of this study.

Generally we have not found it necessary for patients with breasts cysts to undergo closer surveillance than the general population,'' he said.

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