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Analysis of factors predicting surgical intervention and associated costs in pediatric breast masses: a single center study

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Abstract

Purpose

Finding a breast mass in a child provokes apprehension in parents, especially in those with a family history of breast cancer. Clinicians must decide between serial imaging or biopsy of the mass. Herein, we identify management differences in those with and without a positive family history, as well as identify cost differences.

Methods

An institutional retrospective review was performed of patients (2–18 years of age) with a diagnosis of breast mass. Patient demographics, presentation, medical and surgical history, physical exam, imaging, and pathologic diagnosis were collected. Cost data were acquired from the pediatric health information system (PHIS). Costs were compared between patients managed by biopsy versus serial ultrasounds. Bivariate analyses including Pearson’s Chi-square, student’s t tests, and logistic regression were performed.

Results

The probability of biopsy increases with age (p = 0.0001) and female gender (p = 0.006). Biopsy rate is higher for larger masses (p < 0.0001), growing size (p < 0.0001), and in patients with a positive family history of breast cancer (p < 0.0001). The average cost of care for management with initial excisional biopsy was $4491 versus those with serial ultrasounds ($986) (p < 0.0001).

Conclusions

In patients with small lesions, even with a family history of breast cancer, non-operative monitoring is a safe and cost-effective alternative to invasive biopsy.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Ann and Robert H. Lurie Children’s Hospital of Chicago, 225 E Chicago Avenue, Box 63, Chicago, IL, 60611, USA

    E. Graham Englert, Guillermo Ares, Karen Rychlik & Catherine J. Hunter

  2. Feinberg School of Medicine, Northwestern University, 310 East Superior Street, Morton 4-685, Chicago, IL, 60611, USA

    E. Graham Englert, Andrea Henricks & Catherine J. Hunter

  3. Department of Surgery, University of Illinois at Chicago, 840 South Wood Street, Suite 376-CSN, Chicago, IL, 60612, USA

    Guillermo Ares

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  1. E. Graham Englert
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  2. Guillermo Ares
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Correspondence to Catherine J. Hunter.

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Englert, E.G., Ares, G., Henricks, A. et al. Analysis of factors predicting surgical intervention and associated costs in pediatric breast masses: a single center study. Pediatr Surg Int 34, 679–685 (2018). https://doi.org/10.1007/s00383-018-4268-7

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  • DOI: https://doi.org/10.1007/s00383-018-4268-7

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