Welcome back to MasterUSMLE. Today, we’re talking aboutsimple breast cysts, one of the most common benign breast conditions seen in women between 30 and 50 years old.

A patient presents with apainful, mobile breast lump that appeared suddenly. You get anultrasound, and it shows awell-circumscribed, anechoic, thin-walled cyst with no solid components—that’s the classic appearance of a simple breast cyst.

Now, what’s the next step?

• If it’sasymptomatic,no intervention is needed—just observation.
• If it’spainful, you can performfine-needle aspiration to relieve discomfort.
• If aspiration yieldsclear, nonbloody fluid and the cyst disappears completely, no further action is required.
• If the fluid isbloody or the mass persists, that’s a red flag—get a core needle biopsy to rule out malignancy.

No need for mammograms in women under 30 due to dense breast tissue. MRI is also not indicated for a simple cyst.

Key takeaway:Painful cyst? Aspirate it. Clear fluid with complete resolution? No further management. Bloody fluid or persistent mass? Biopsy.

That’s it for today—keep it simple, stay sharp, and I’ll catch you next time on MasterUSMLE!