[Differential diagnosis of intracystic breast lesions in hemorrhagic cysts].

The authors report on 117 consecutive hemorrhagic breast cysts cases. All patients underwent cytologic examination of cystic fluid content and US or pneumocystography. Ten cancers (9 infiltrating, and 1 lobular in situ) and 22 papillomas had histologic confirmation--out of 45 cases undergoing surgical biopsy. Seventy-two cases exhibiting no intracystic growth have been followed for 5.4 years on the average and no cancer has developed so far. Pneumocystography or US had 100% predictive value for intracystic lesions; we observed that surgical biopsy could be safely avoided when both examinations were negative, that is in about 3/4 cases. No differential diagnosis of cancer and papilloma was possible on pneumocystography or US. Even though positive cytology was highly predictive for cancer, cytology exhibited poor sensitivity and surgical biopsy was necessary in all cases presenting with intracystic growth.