Breast Masses In Children
Abstract
Objective: The overwhelming majority of breast masses in children are benign. In this paper we aimed to evaluate the breast masses in children.
Methods: All children younger than 18, who were diagnosed with breast mass and were admitted to our center between March 2012 and March 2014 were analyzed for age, gender, complaint, the history of malignancy, the localization of breast mass, sonographic and pathological findings, and the diagnosis, retrospectively.
Results: Twenty-nine girls and 8 boys (age ranges from 5 to 18) were admitted to our center with breast mass within the last two years. Except for mass, 5 patients had pain, and 8 patients had nipple discharge. Two patients had family history of breast cancer. Three patients had an operation of mass excision. Histopathological diagnosis of two patients were juvenile fibroadenoma, and pseudoangiomatous stromal hyperplasia. Other diagnoses according to clinical and sonographic features were: Fibroadenoma 11, gynecomastia 8, breast abscess 6, premature thelarche 3, mammary duct ectasia 2, accessory breast 1, fibrocystic change 1 and adenosis 1. Patients were followed up with ultrasound and none of them developed malignacy.
Conclusion: The prevalence of breast cancer in the pediatric age group is extremely low, so a conservative approach of clinical and sonographic follow-up is more commonly adopted in children.
References
Pruthi S, Jones KN, Boughey JC, et al. Breast masses in adolescents: Clinical pearls in the diagnostic evaluation. American Family Physician 2012; 86: 325-6.
Kerlikowske K, Smith-Bindman R, Ljung BM, Grady D. Evaluation of abnormal mammography results and palpable breast abnormalities. Ann Intern Med. 2003; 139: 274-84.
Simmons PS, Jayasinghe YL, Wold LE. Breast carcinoma in young women. Obstet Gynecol. 2011; 118: 529-36.
Bobo JK, Lee NC, Thames SF. Findings from 752,081 clinical breast examinations reported to a national screening program from 1995 through 1998. J Nat Cancer Inst. 2000; 92: 971-6.
Kaneda HJ, Mack J, Kasales CJ, Schetter S. Pediatric and adolescent breast masses: A review of pathophysiology, imaging, diagnosis, and treatment. American J Radiol. 2013; 200: 204-2.
Cerrato F, Labow BI. Diagnosis and management of fibroadenomas in adolescent breast. Semin Plast Surg. 2013; 27: 23-5.
Divasta AD, Weldon C, Labow BI. The breast: examination and lesions. In: Emans SJH, Laufer MR, eds. Pediatric and Adolescent Gynecology. 6th ed. Philadelphia, PA: Lippincott, Williams and Wilkins; 2012: 405-20.
Kronemeyer KA, Rhee K, Siegel MJ, et al. Gray scale sonography of breast masses in adolescent girls. J Ultrasound Med. 2001; 20: 491-6.
Garcia CJ, Espinoza A, Dinamarca V, et al. Breast US in children and adolescents. Radiographics 2000; 20: 1605-12.
Chung EM, Cube R, Hall GJ, et al. From the archives of the AFIP: breast masses in children and adolescents: radiologic-pathologic correlation. Radiographics 2009; 29: 907-31.
Williams SM, Kaplan PA, Petersan JC, Lieberman RP. Mammography in women under age 30: is there clinical benefit? Radiology 1986; 161: 49-51.
Bock K, Duda VF, Hadji P, et al. Pathologic breast conditions in childhood and adolescence. J Ultrasound Med. 2005; 24: 1347-54.
Jayasinghe Y, Simmons P. Disorders of the young breast. In: Altchek A, Deligdisch L, eds. Pediatric, Adolescent and Young Adult Gynecology. Oxford, UK: Wiley-Blackwell; 2009: 256-64 .
Simmons P, Wold L. Surgically treated breast disease in adolescent females: a retrospective review of 185 cases. Adolesc Pediatr Gynecol. 1989; 2: 95-8.
West KW, Rescoria FJ, Scherer LR, et al. Diagnosis and treatment of symptomatic breast masses in the pediatric population. J Pediatr Surg. 1995; 30: 182-7.
Arca JM, Caniano DA. Breast disorders in the adolescent patient. Adolesc Med. 2004; 15: 473-85.
Welch ST, Babcock DS, Ballard ET. Sonography of pediatric male breast masses: gynecomastia and beyond. Pediatr Radiol. 2004; 34: 952-7.
Huneuus A, Schilling A, Horvath E, et al. Retroareolar cysts in the adolescent. J Pediatr Adolesc Gynecol. 2003; 16: 45-9.
Sanchez R, Ladino-Torres MF, Bernat JA, et al. Breast fibroadenomas in the pediatric population: common and uncommon sonographic findings. Pediatr Radiol. 2010; 40: 1681-9.
Greydanus DE, Matytsina L, Gains M. Breast disorders in children and adolescents. Prim Care 2006; 33: 455-502.
Wieman SM, Landercasper J, Johnson JM, et al. Tumoral pseudoangiomatous stromal hyperplasia of the breast. Am Surg. 2008; 74: 1211-4.
Powell CM, Cranor ML, Rosen PP, Pseudoangiomatous stromal hyperplasia(PASH): a mammary stromal tumor with myofibroblastic differentiation. Am J Surg Pathol 1995; 19: 270-7.
Kennedy G, Markert M, Alexander JR, et al. Predictive value of BI-RADS classification for breast imaging in women under age 50. Breast Cancer Res Treat. 2011; 130: 819-23.