omplex breast cyst

[Deanna1018]

I am 36 years old. I have received mammograms since the age of 30 due to a strong family history of breast cancer. I had  a routine mammogram yesterday, further films were done due to the density of the breast tissue in one area of my left breast. It was then decided that an ultrasound was warranted due to my family history. During the ultrasound the DR found nothing in the area of question but found what she think might be a complex cyst in another part of the breast. She did 2 needle aspirations right there and due to my family history is getting a stat  reading of the fluid aspirated(she stated this even before she did the aspiration). She said nothing on the ultrasound was a red flag that indicated cancer but she wanted to be safe. She also stated that the mammogram showed nothing to indicate there was cancer in the area she aspirated.
Ok now for my questions...1) What is the percetage rate of cancer related to complex cysts?
2) What should the discharge look like from a normal aspiration as opposed to an abnormal one (some research I have read says bloody for normal and bloody for abnormal)? Unfortunately I didn't see what color it was I was still in shock.
3) How effective are mammagrams when it comes to detecting breast cancer? I am trying to find some comfort in that the mammogram didn't show anything in the area where she did the aspiration.
4) I have also read that alot of aspiration results come back as false positives and that a core biopsy should be done initially. What are your thoughts on this?

Thanks for any insight you can give me

Deanna

[CCF-RN,MSN-JS]

Dear Deanna:  A complex breast cyst is a description of a cyst that does not meet the strict criteria used to describe a "simple" breast cyst (fluid-filled structure) on ultrasound exam.   Breast cysts are not usually considered a risk factor for breast cancer.   Cysts themselves are almost never malignant.  The fluid aspirated from a cyst can be almost any color - usually green, brown or yellow.  Bloody  fluid would be more concerning that something else was going on and further evaluation would likely be pursued.   When talking about false positives in terms of fluid from an aspirated cyst, sometimes the fluid has been around awhile within the cyst so when it is examined under the microscope the cells may look abnormal, not necessarily because of a problem, but because they have been hanging around awhile.  Whether or not a biopsy is done, and the type of biopsy to be done is determined based on findings of the ultrasound, mammogram, location of a lump, as well as the findings now from the aspiration.  
Mammograms are x-rays done to evaluate the breast tissue looking for anything unusual or suspicious.  An abnormal finding on a mammogram may be more or less suspicious for cancer,  but can also be present due to a number of benign (non-cancerous) conditions.  Further evaluation (biopsy) of a suspicious finding would be necessary to actually diagnose a cancer.  

[Deanna1018]

Just received the phone call from the DR. It wasn't a complex cell like she originally thought. The pathology report stated consistent with fibrocystic changes. So they are going to do another ultrasound in 3 months to check the area again. I did ask her about the increased incidence of breast cancer with these changes and she said not high. I have a higher risk due to my family history. What is the thought on incidence of breast cancer occuring when you have preexisting fibrocystic changes? Also is it common practive to have a follow up ultrasound so soon. Don't get me wrong I love that I am being monitored this closely I just would like to know what common practice is. The Dr stated that it is the practice of her facility to do a follow up ultrasound to check on the site. Thanks

Deanna