Highlights
- •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.
Abstract
Background
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.
Results
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.
Conclusions
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.
Keywords
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Article info
Publication history
Published online: April 09, 2021
Accepted:
January 18,
2021
Received in revised form:
December 18,
2020
Received:
October 5,
2020
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
