Breast cysts after menopause: what to know

A cyst is a pocket of fluid in breast tissue. Cysts often feel round or oval and may be tender, but their feel varies. After menopause, the breasts are no longer following a monthly hormonal cycle, so a new lump should not be assumed to be a familiar cyclical change.

Clinical examination and breast imaging are used to identify whether the area is fluid-filled or solid and whether it has reassuring features. Depending on the findings, a clinician may recommend observation, aspiration of fluid, another scan or sampling of tissue.

Book a breast assessment for a newly noticed lump, even if it is soft, mobile or not painful. Record when you first noticed it and mention any previous cysts, breast procedures, family history and hormone medicines. Bring earlier breast images or reports if they are available, because comparison may help the clinician interpret a current finding.

Do not squeeze, massage or attempt to drain the area yourself. If a clinician drains a cyst, follow the advice given about watching for refilling, redness or worsening pain. Keep attending any breast screening offered to you, while remembering that screening does not replace assessment of a symptom.

Request prompt medical review if the lump enlarges, feels hard or fixed, returns after drainage, or occurs with puckered skin, a newly turned-in nipple, spontaneous nipple discharge, a change in breast contour, or an armpit lump. These signs guide urgency; none can determine the diagnosis on its own.

Seek urgent help for rapidly increasing redness, heat and swelling of the breast, particularly if accompanied by fever, chills or feeling acutely unwell. This pattern can occur with an infection that needs timely assessment.

Useful questions include whether imaging shows a simple cyst, whether aspiration or tissue sampling is advised, and what follow-up is planned. Ask how any menopausal hormone treatment relates to your breast symptoms and which specific changes should lead to an earlier return.