2X Needle Guided Breast Cyst Removal '02 § '03 - New Cyst

[SUZIECB]

1/2002 I had two large cysts removed from R Breast due to needle biopsy questionable.  Recovered well. 1/2003 had another large cyst removed from same area.  After surgery I noticed that the original cyst was still there.  Doctor said she felt the area and could not find any other pathology.  I forgot to mention that I have had bloody discharge prior to 2002 - it comes and goes.  This is spontaneous occasionally.   I have had a follow up x2 s/p and the "lump" remains.  The doctor just wants to watch it.  Went for a second opionion and that doctor wants to remove it - calls it a "inclusive cyst".  He never looked at any films or other studies - nor when questioned he did not want surgery or path reports.  So I am just hanging out and wondering what to do?  I have read and read that breast cyst are nothing to worry about.  But one sided breast cysts and discharge is that normal?
Thank you for your time and help.

[CCF-RN,MSN-rf]

Dear SUZIECB:  Breast cysts on one side are perfectly normal.  Spontaneous bloody discharge on one side is not typical.  Perhaps you need an opinion from a breast specialist who can evaluate your problem both from the historical and current perspective.

[surgeon]

a simple cyst, meaning one with a thin wall containing clear yellowish fluid, is indeed nothing to worry about. I assume the cysts you had removed were things that showed on mammogram, and weren't feelable. If they were feelable, they could have been dealt with by draining with a thin needle. If they showed only on xray, and on ultrasound were seen to be typical cysts, it would have been ok to leave them alone. It's not clear what was going on to have led to the decision to remove them. Be that as it may, you have two issues that need attention: bloody discharge needs an answer: simple cysts don't cause that. If the blood can be seen to occur only in one opening on the nipple, a duct excision operation can be done. It's fairly minor. Likely it's innocent -- it usually is. But cancer can cause blood, too, and it's important to be sure. The other issue is the lump. You put the word in quotes, so I'm not sure if you mean it's not really a lump that can be felt. If it is, then it would be simple to sample it also with a needle. Or surgically remove it. Not all lumps need removal or biopsy, however, if there is reason to be confident it's ok. In your case if it's been there a long time without change, it may be that your surgeon is confident enough to follow it without further procedure.