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Complex breast cyst on Mammogram. The challenge is to differentiate a complicated breast complicated cystic mass a complex cyst as the low internal echos of a complicated cyst may appear as a homogeneous hypoechoic mass 4. So, I hope you relax about the lobulated cyst. J Ultrasound Med. Having cysts along with other breast cancer risk factors, such as a strong family history, leads many breast complicated cystic mass to do this. Simple and complicated cysts are the most common cystic breast lesions.