[2026-09-30] Outcomes of Clustered Microcysts on Breast Ultrasound

Duangporn Thattinaphanich; Cholatip Wiratkapun

doi:10.33165/rmj.2027.e279518

Authors

Duangporn Thattinaphanich Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand https://orcid.org/0009-0009-9168-5255
Cholatip Wiratkapun Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand https://orcid.org/0000-0002-2867-0634

DOI:

https://doi.org/10.33165/rmj.2027.e279518

Keywords:

Clustered microcysts, Ultrasound, Benign breast lesion, Breast cancer screening, Follow-up

Abstract

Background: Clustered microcysts, which are common incidental findings on breast ultrasound, present challenges due to limited information about outcomes and controversial management recommendations.

Objective: To evaluate the outcomes of lesions classified as clustered microcysts on breast ultrasound images through histopathological diagnoses and follow-up examinations.

Methods: From January 2012 to December 2022, 505 female patients with 556 clustered microcysts, defined as a group of small anechoic masses separated by thin septa without solid component, were included in this retrospective study to assess the incidence of breast cancer. Clinical data, imaging findings, and histopathological data were reviewed. The additional dichotomous outcome of an increase in maximal diameter exceeding 20% was determined at 24 months. The data were analyzed using standard descriptive statistics and logistic regression to assess the associations between the factors of interest and outcomes.

Results: The mean (SD) age of the 505 female patients was 47.54 (10.35) years, with an incidence of clustered microcysts of 0.59% (95% CI, 0.55%-0.63%) among 125 616 breast ultrasounds. Of 556 lesions, 15 lesions were histopathologically benign. Among 541 lesions with at least one follow-up, 346 (63.96%) resolved spontaneously. In the subset of 462 lesions with at least 24 months of follow-up, no malignancies were identified, and 8 lesions (1.73%) increased in size > 20% over 24 months. However, all 8 lesions were subsequently classified as benign (BI-RADS 2) at the last follow-up examination (median follow-up, 40 months). Age ≥ 60 years was the only significant risk factor for progression (odds ratio, 6.21; 95% CI, 2.02-19.10; P = .001).

Conclusions: No malignancies were identified in this study. The findings support the benign nature of clustered microcysts and recommend annual follow-up, even though a small subset exhibited progression at 24 months follow-up.

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