Breast Cyst with Debris

Hi, I just had an ultrasound for an abnormality found in my breast from a routine mammogram. The abnormality is 9 centimeters. My doctor cannot feel it doing an exam, and I cannot feel it either.  

The technician did pictures, then the radiologist came in and spent about 20 minutes moving me into different positions to try and get the debris to move.  Apparently the cyst did move around.   He could not get the debris to move around and recommended a follow up ultrasound in 6 months.  

I went back and questioned my doctor.  She checked with a surgeon who told us they "might be able to drain it only if there was an obvious lump there".   How can there not be an obvious lump?  It is about 3-1/2 inches and is very apparent in the mammogram and ultrasound, but not to the touch.  I don't even get this.  It is 8 centimeters south of my nipple.  The radiologist told my doctor,  "I can't simply drain it because it is complicated. I would need to do a vacuum core biopsy with clip placement to mark the location. If she wishes to proceed with that she can contact us."

I have researched vacuum core biopsy and understand what is involved. I do not understand why it requires this. I do not understand why is cannot be aspirated when they can see it fine with imaging.   I don't know if I should wait 6 months.  I am totally confused.  I am working with my doctor and want to gain as much knowledge as possible before speaking with her again.

I will be 56 in two months. My mother and her sister were diagnosed with breast cancer at age 49 and both died at the age of 55..when I was 24.

Can you enlighten me on any of this?  I feel there is a missing piece to this and I'm just not catching what it is.

Thank you very much for any help you can give me.

[japdip]

Well, for one thing this cyst can be deep in the breast tissue; the reason for it not being palpable. the clip placement would be done in the Radiology Dept to mark the location so that the biopsy could be performed on the exact location without the chance of missing the finding. With a cyst containing debris a needle aspiration can easily fail since the debris might not pass thru the needle and a sufficient sample may not be possible. This seems to be the best option rather than have the simple draining procedure and in the end have no results. Considering your family history a biopsy would be the best way to go as I know you want a definite answer when all is said and done.  Regards .....