Definition & Overview

A puncture aspiration is a medical procedure used to remove a cyst (an abnormal fluid-filled lump) from the breast. Some of them may grow too large or cause some pain, so they are removed. To remove them, doctors drain the fluid inside the cyst. A puncture aspiration is an effective way to do so and to find out if a cyst is cancerous or not.

Who Should Undergo and Expected Results

A puncture aspiration is good for people who have a cyst in the breast. The procedure can:

  • Remove the cyst
  • Determine if the cyst is cancerous or not


It is especially effective for most fluid-filled cysts, such as hydatid cysts, but can only be used for uncomplicated cysts.

A breast cyst is a lump in the breast that contains fluid. There are two kinds of cysts. Microcysts are small cysts that cannot be felt on the outside and can only be detected by an ultrasound or mammogram. Macrocysts are larger cysts that can be felt on the outside. They can grow up to 2 inches in diameter. These larger cysts are most likely to cause pain and other potential problems.

Breast cysts can be caused by several possible reasons, such as hormonal changes and high oestrogen levels.

There are three possible results after a puncture aspiration. The results give the doctors more important information about the cyst.

  • The fluid drains out and the cyst disappears
  • The fluid drains out but the cyst does not disappear; the fluid can also be bloody
  • No fluid is drained out


If the doctor successfully drains fluid out and gets rid of the cyst, the patient can go home without other treatment. The fluid taken from the cyst can also be thrown away. But if the fluid is bloody and the cyst does not disappear, the doctor will send the fluid to a laboratory. Doctors who specialise in dealing with cysts will further examine it to determine its composition. These doctors are called cytologists. They can determine whether the cyst is cancerous or not.

If the doctor does not drain out any fluid, this means that the cyst is made up of solid material. If so, the doctor will want to get a sample of it through a biopsy to check for cancer cells. Solid breast lumps cannot be removed through puncture aspiration. They can only be removed through surgery.

How is the Procedure Performed?

A puncture aspiration of a breast cyst is a quick and simple procedure. During the procedure, doctors use ultrasound or a mammogram as their visual guide. These help them locate the cyst.

The following are the steps taken to perform the procedure:

  • The patient is asked to lie on her back on the exam table. She will be asked to remove her upper body clothes and raise one arm above her head.
  • The patient will be given local anaesthesia. This way, she won’t feel any pain during the procedure.
  • The doctor will put a clear gel on the patient’s breast. Next, the doctor will press an ultrasound transducer or probe on the patient’s breast to find the cyst.
  • Once the cyst is found, the patient’s breast is cleaned. The needle is then inserted all the way into the cyst.
  • The doctor will then aspirate the contents of the cyst through the needle.
  • The puncture site is then covered with a dressing or bandage.


If the patient’s cyst is too small, doctors use mammograms instead of ultrasound.

Patients who undergo puncture aspiration of a breast cyst should visit their doctor after 4 to 6 weeks. This way, the doctor can check if the cyst has not filled up with fluid again. If the cyst fills up with fluid again, the patient will have to undergo more tests to check for underlying problems that may be causing the recurrent cysts.

Possible Risks and Complications

The puncture aspiration of a cyst in the breast may be painful or uncomfortable for some patients. The procedure is also not free from risks. Patients who have their breast cyst aspirated through this procedure are at risk of:

  • Breast pain
  • Bruising
  • Infection
  • Bleeding
  • Punctured blood vessels


Patients who have breast implants are also at risk of having their implants punctured by mistake during the procedure. This is more likely to occur if the cyst is too close to the implants.

If the cyst is deep within the breast, patients may also face the risk of lung perforation and lung collapse.

Aside from that, patients who undergo puncture aspiration can get cysts again. Cysts can fill up with fluid again on the same site, or new cysts can also grow.

References:

  • Borecky N. “Breast fine needle aspiration.” The Royal Australian and New Zealand College of Radiologists. 2015 Oct 28. http://www.insideradiology.com.au/pages/view.php?T_id=59#.V77juYQz7dk

  • Park KH, Jung Si, Jang HC, Shin JH. “First successful puncture, aspiration, injection, and re-aspiration of hydatid cyst in the liver presenting with anaphylactic shock in Korea.” Yonsei Medical Journal. 2009 Oct 31, 50(5): 17-720. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2768250/

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