Abstract
Purpose
Breast masses in children and adolescents are uncommon and the vast majority are benign. There are currently limited analyses of breast masses in this population and clinical management is highly variable between institutions and providers. The purpose of our study is to analyze the demographics, pathology and management of 119 pediatric patients with breast masses; one of the largest studies to date.
Methods
We performed a retrospective review of patients who underwent excision of a breast mass at a single pediatric center from June 2009 to November 2013. Demographics, imaging, pathology and management were reviewed.
Results
Average patient age was 15.3 years, average mass size was 3.15 cm and 20.3 % had a family history of breast cancer. 68 % of patients had pre-operative ultrasound, and 31.9 % underwent a period of observation. The most common indication for resection was patient and family anxiety. All masses were benign, with fibroadenoma being the most common histopathology (75.2 %).
Conclusions
In our cohort there were no cases of malignancy. Only 31.9 % of patients underwent some form of observation and patient or family anxiety was the most common indication for proceeding with surgery. This suggests that patient anxiety may result in unnecessary operation. Our data may help reassure patients, families and providers that the risk of malignancy is low and could help develop more optimal management strategies.
Similar content being viewed by others
References
Neinstein LS, Atkinson J, Diament M (1993) Prevalence and longitudinal study of breast masses in adolescents. J Adolesc Health 13:277–281
Kaneda HK, Mack J, Kasales CJ, Schetter S (2013) Pediatric and adolescent breast masses: a review of pathophysiology, imaging, diagnosis and treatment. Am J Roentgenol 200:W204–W212
Fallat ME, Ignacio RC (2008) Breast disorders in children and adolescents. J Pediatr Adolesc Gynecol 21:311–316
Gutierrez JC, Housri N, Koniaris LG, Fischer AC, Sola JE (2008) Malignant breast cancer in children: a review of 75 patients. J Surg Res 147:182–188
Jayasinghe Y, Simmons PS (2009) Fibroadenomas in adolescence. Curr Opin Obstet Gynecol 21:402–406
De Silva NK, Brandt ML (2006) Disorders of the breast in children and adolescents, part 2: breast masses. J Pediatr Adolesc Gynecol 19:415–418
Sklair-Levy M, Sella T, Alweiss T, Cracium I, Libson E, Mally B (2008) Incidence and management of complex fibroadenomas. AJR Am J Roentgenol 190(1):214–218
Greenberg R, Skornick Y, Kaplan O (1998) Management of breast fibroadenomas. J Gen Intern Med 13:640–645
Koning JL, Davenport KP, Poole PS, Kruk PG, Grabowski JE (2015) Breast imaging-reporting and data system (BI-RADS) classification in 51 excised palpable pediatric breast masses. J Pediatr Surg 50(10):1746–1750
West KW, Rescorla FJ, Scherer LR, Grosfeld JL (1995) Diagnosis and treatment of symptomatic breast masses in the pediatric population. J Pediatr Surg 30:182–187
Bock K, Duda VF, Hadji P, Ramaswamy A, Schulz-Wendtland R, Klose KJ, Wagner U (2005) Pathologic breast conditions in childhood and adolescence: evaluation by sonographic diagnosis. J Ultrasound Med 24:1347–1354
Tea MKM, Asseryanis E, Kroiss R, Kubista E, Wagner T (2009) Surgical breast lesions in adolescent females. Pediatr Surg Int 25:73–75
Ezer SS, Oguzkurt P, Ince E, Temiz A, Bolat FA, Hicsonmez A (2013) Surgical treatment of the solid breast masses in female adolescents. J Pediatr Adolesc Gynecol 26:31–35
Vargas HI, Vargas MP, Eldrageely K, Gonzalez KD, Burla ML, Venegas R, Khalkhali I (2005) Outcomes of surgical and sonographic assessment of breast masses in women younger than 30. Am Surg 71:716–719
Frazier AL, Rosenberg SM (2013) Preadolescent and adolescent risk factors for benign breast disease. J Adolesc Health 52:S36–S40
Ahlgren M, Melbye M, Wohlfahrt J, Sorensen TIA (2004) Growth patterns and the risk of breast cancer in women. N Engl J Med 351:1619–1626
Berkey CS, Willett WC, Frazier AL, Rosner B, Tamimi RM, Colditz GA (2011) Prospective study of growth and development in older girls and risk of benign breast disease in young women. Cancer 8:1612–1620
D’Orsi CJ, Bassett WA et al (2003) Mammography. Breast imaging reporting and data system (BI-RADS), 4th edn. American College of Radiology, Restona, pp 1–259
Kennedy RD, Boughey JC (2013) Management of pediatric and adolescent breast masses. Semin Plast Surg 27:19–22
Michala L, Tsigginou A, Zacharakis D, Dimitrakakis C (2015) Breast disorders in girls and adolescents. Is there a need for a specialized service? J Pediatr Adolesc Gynecol 28:91–94
Vade A, Lafita VS, Ward KA, Lim-Dunham JE, Bova D (2008) Role of breast sonography in imaging of adolescents with palpable solid breast masses. AJR Am J Roentgenol 191:659–663
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Knell, J., Koning, J.L. & Grabowski, J.E. Analysis of surgically excised breast masses in 119 pediatric patients. Pediatr Surg Int 32, 93–96 (2016). https://doi.org/10.1007/s00383-015-3818-5
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-015-3818-5