What is a common reason to aspirate a breast cyst?

• A. Symptomatic and palpable
• B. Asymptomatic on routine screening only
• C. To confirm malignancy in all cases
• D. Only when the patient requests

Answer: (A)

A common reason to aspirate a breast cyst is when it is symptomatic and palpable. When a cyst causes pain, tenderness, or noticeable swelling, removing some of the fluid can immediately relieve discomfort and decompress the cyst. Aspiration also serves a diagnostic role: it confirms the cystic nature by yielding fluid and often revealing that the cavity collapses, which supports a benign simple cyst rather than a solid mass. The procedure is typically done under ultrasound guidance to ensure precise needle placement and safety. If the aspirated fluid is clear and the cyst collapses, reassurance is possible and routine follow-up may be enough. If the cyst recurs, the aspirate is bloody, or imaging suggests solid components, further evaluation is needed to exclude malignancy. In contrast, asymptomatic cysts found on routine screening are usually observed rather than aspirated. Aspirating to confirm cancer in all cases is not appropriate; that would lead to unnecessary procedures, with biopsy reserved for suspicious findings.