Research Article| Volume 264, P309-315, August 2021

Management of Pediatric Breast Masses: A Multi-institutional Retrospective Cohort Study

Published:April 09, 2021DOI:


      • Most pediatric and adolescent breast masses are benign.
      • The most common reasons for pediatric lumpectomy are lesion size and growth.
      • BI-RADS classification may not be useful in evaluation of pediatric breast masses.
      • It is safe to monitor most breast masses for growth prior to surgical excision.



      The objective of our study was to describe the workup, management, and outcomes of pediatric patients with breast masses undergoing operative intervention.

      Materials and methods

      A retrospective cohort study was conducted of girls 10-21 y of age who underwent surgery for a breast mass across 11 children's hospitals from 2011 to 2016. Demographic and clinical characteristics were summarized.


      Four hundred and fifty-three female patients with a median age of 16 y (IQR: 3) underwent surgery for a breast mass during the study period. The most common preoperative imaging was breast ultrasound (95%); 28% reported the Breast Imaging Reporting and Data System (BI-RADS) classification. Preoperative core biopsy was performed in 12%. All patients underwent lumpectomy, most commonly due to mass size (45%) or growth (29%). The median maximum dimension of a mass on preoperative ultrasound was 2.8 cm (IQR: 1.9). Most operations were performed by pediatric surgeons (65%) and breast surgeons (25%). The most frequent pathology was fibroadenoma (75%); 3% were phyllodes. BI-RADS scoring ≥4 on breast ultrasound had a sensitivity of 0% and a negative predictive value of 93% for identifying phyllodes tumors.


      Most pediatric breast masses are self-identified and benign. BI-RADS classification based on ultrasound was not consistently assigned and had little clinical utility for identifying phyllodes.


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