Sebaceous Cyst of the breast

Sebaceous cysts can form when the sebaceous glands become blocked. The sebaceous glands secrete ‘sebum’. Sebum is an oil that lubricates the hair and skin.

There are sebaceous glands in many areas of the body, but they are most abundant on the face neck and scalp. A sebaceous breast cyst is a type of epidermal cyst, that forms as a collection of keratin-like material.

Usually, this type of breast cyst will have a small opening to the skin, but this may not be easily visible. These cysts most commonly appear on the face, the back of the ears, neck, back and torso. However, these cysts can also occur on the breast.

If you notice any type of small lump on your breast you should always seek medical advice from your family physician. This is true even if you think you have a breast cyst.

Euh! What is that picture up there, Doc?

The round white nodule on the bottom-left of the mammogram above, looks like it might be inside the breast. However, it turned out to be a sebaceous cyst located just below the skin.

Symptoms of the Sebaceous Cyst

Often, this type of cyst appears as a small bump or lump just beneath the skin. So, you can picture them as small, closed ‘sacs’, that contain keratin. Keratin is a protein that protects the skin cells from damage or stress.

Sometimes, these cysts can smell foul, but often they have no odour.

Because these cysts origin from skin-related tissue, they are also called epidermoid cysts. I suppose you could call them ‘skin cysts‘. Because these cysts may contain skin oils in the keratinized materials, the whitish contents can look shiny and feel slippery, sometimes.

Are a cyst and a boil the same thing?

Unlike cysts boils are infected with bacteria. Boils usually occur in a hair follicle or gland.

Treatment of Sebaceous Breast Cysts

Usually, medical professionals will not remove the breast cyst unless it is cosmetically upsetting to the patient or you have infected cysts. If a breast cyst is infected it will appear swollen and red and can be quite painful.

Your doctor may prescribe antibiotics to bring the inflammation down and treat the infection. Often a sebaceous cyst will not require any treatment and may well dry up and disappear. However, sometimes doctors will surgically excise these breast cysts.

There is no need for a general anesthetic for surgical removal of a breast cyst, surgeons will perform this under local anesthetic. However, it is important for the surgeon to remove all of the cyst wall otherwise there is a high likelihood of recurrence.

Why do people get skin cysts, Doc?

Well, let’s take a quick look …

What causes skin cysts?

Skin cysts form when multiplying skin cells move inwards into the deeper, dermis layer of the skin. Usually, the skin cells will move to the top layer of the skin (epidermis) and shed away.

Several factors cause sebaceous cysts and these include:-

Blocked sebaceous or oil glands in the skin
Swelling of the hair follicle or a hair that grows inwards
Over production of the oil sebum
Injury or burn to the skin
Shaving and waxing

Can you not just squeeze and pop a cyst?

No, not recommended due to the risk of infection and possible scarring.

Also, that would be really painful I would think.

Are Breast Cysts linked with Cancer?

Sebaceous breast cysts are totally benign (non-cancerous) and have nothing to do with breast cancer. These type of cysts do not increase breast cancer risk in any way.

A cyst is a sac that contains, air, fluid or semi-solid material. In the case of the sebaceous cyst, the inside of the sac contains epidermoid material. Epideromoid material is wet and appears a bit like dandruff clumped together.

On the other hand a breast tumor is an abnormal mass of solid tissue. Cysts with solid material inside are a little more suspicious than air or fluid-filled ones. However, a biopsy will determine if any lump or bump is benign or cancerous.

Questions and Answers

What is the difference between epidermoid and pilar cysts?

Interestingly, both these types of cysts come under the heading of ‘sebaceous’, although neither are true sebaceous cysts. Both epidermoid and pilar cysts contain keratin.

The only difference is that, as the name suggests, epidermoid cysts originate from the skin (epidermis) and pilar cysts originate from the hair follicles.

Are Sebaceous Breast Cysts linked to Cancer

No, these cysts are benign skin lumps that are usually slow growing. However, some can swell to the size of a golf ball. These types of cysts are not linked to cancer in any way.

References

Shaikh, MH., Baviskar, PK., Mahske, AN. Sebaceous cyst in the breast: A Rare Presentation. Bombay Hospital Journal. (April 2011)Volume 53 No. 02.
Kalli S, Freer PE, Rafferty EA. Lesions of the skin and superficial tissue at breast MR imaging. Radiographics. (2010) 30 (7): 1891-913.
Iglesias A, Arias M, Santiago P et-al. Benign breast lesions that simulate malignancy: magnetic resonance imaging with radiologic-pathologic correlation. Curr Probl Diagn Radiol. (april 2007)36 (2): 66-82.