Complex breast cysts; strong family history

[puppeteer]

I am 36 years old and have a strong family history of breast cancer (sister 34). As a result, I have annual mammograms, and this time, I had an ultrasound as well.

I have not received the full lab results yet, but the radiologist made it clear that I have both simple and complex cysts. These are hidden beneath a strip of extremely dense tissue (asymmetrical density), so nothing can be seen on a mammo.

I have seen several posts on the issue of complex cysts. My question is how far should I follow up on this given my family history? I don't think watchful waiting is wise, but should I go so far as to have the cysts excised rather than just aspirated with the fluid biopsied?

[CCF-RN,MSN-rf]

Dear Puppeteer:  Simple cysts are by definition benign (fluid-filled) structures.  Complex cysts have solid components to them.  While aspirating fluid from a simple cyst is the way to treat them, complex cysts are not so easily aspirated due to the fluid being "compartmentalized."  Further, cystic fluid is rarely diagnostic.  The concern with complex cysts is not the fluid - it is the solid parts, although these are usually benign as well.  When these are further examined it is usually to make certain that these are, in fact, cysts.  You may benefit from seeing a breast specialist who can help you with decisions as to what should be done to follow up on these results.