Breast Cyst Aspiration (drainage) The procedure for aspirating (draining) one or more breast cysts is a minor and simple one. The patient will be asked about medications and allergies (women who are taking aspirin or blood thinners should let us know well in advance of their procedure, as they are at a higher risk for bleeding and bruising). The physician will explain the procedure to the patient and a consent form will be signed. The patient will be positioned on the ultrasound table. Usually the arm (on the cyst side) is positioned overhead. Depending on where the cyst is, a wedge pillow may be placed under the patient. Both of these maneuvers help to stabilize the breast tissue and make draining the cyst easier for both the doctor and the patient. The person assisting the doctor can help with keeping the patient comfortable. The patient should feel free to ask for anything she needs. The skin of the breast is cleaned with an iodine-based solution called Betadine . If the patient is allergic to Betadine, rubbing alcohol is used to prepare the skin. The doctor puts on sterile gloves and drapes the patient’s prepared breast with sterile towels. The ultrasound transducer is draped in a sterile manner with a plastic or latex cover. The patient is often used as a table for the procedure. The ultrasound is laid on the sterile towels to keep the ultrasound sterile. The doctor prepares the sterile equipment. There will be a syringe used for numbing the breast with lidocaine. The doctor will use a large needle to draw up the lidocaine into this syringe. The needle will be changed to a very fine one that is used to deliver the local anesthesia (numbing). There will also be a syringe used for withdrawing the fluid from the cyst. This syringe is attached to extension tubing, so the assistant can apply the suction needed to drain the fluid. There may also be gauze, Polysporin ointment, and a Band-Aid . The doctor will use the ultrasound to locate the cyst. Sometimes, the patient is able to see the ultrasound screen and observe the procedure. The doctor will be able to watch her numbing needle advance to numb the area. She will then advance the cyst-draining needle to the area. Suction will be applied once the needle is within the cyst. Fluid will be withdrawn until the area is no longer visible by ultrasound. If the cyst was originally seen on a mammogram, the doctor may take another mammogram to verify that the area in question is gone. This depends on each woman’s particular situation. Once the procedure is done, the breast is cleaned off (all the Betadine is removed). A dab of Polysporin ointment is applied with a Band-Aid to cover the cyst aspiration site. There are no special instructions after a cyst aspiration. If there is any discomfort after the lidocaine has worn off, the patient can take Tylenol for pain and/or use an ice bag off and on to the area. Bruising is not unusual, but is not frequent. Often, patients are consented for both a cyst aspiration procedure and a biopsy procedure. We do this just in case we do not get fluid from an area we believe to be cystic. If we advance the cyst-aspiration needle to an area and cannot get fluid back, we would then change the procedure to a core biopsy.