TY - JOUR
T1 - Pediatric breast masses
T2 - an argument for observation
AU - McLaughlin, Cory M.
AU - Gonzalez-Hernandez, Jessica
AU - Bennett, Monica
AU - Piper, Hannah G.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Background: Pediatric breast masses can be a diagnostic challenge. Nearly all are benign, but there is no consensus on which should be removed. We hypothesized that children with asymptomatic breast lesions can be safely managed nonoperatively. Methods: We performed a single-institution retrospective review of children (≤18 y) who underwent breast mass excision from 2008 to 2016. Male patients with gynecomastia and those who had needle biopsy without formal excision were excluded. Pearson correlation was used to compare ultrasound and pathologic size. Kruskal–Wallis test was used to compare size and final diagnosis. Results: One hundred ninety-six patients were included (96% female). Mean age was 15 ± 3 y. Most patients (71%) presented with a painless mass. Preoperative ultrasound was obtained in 70%. Pathology included fibroadenoma (81.5%), tubular adenoma (5%), benign phyllodes tumor (3%), benign fibroepithelial neoplasm (0.5%), and other benign lesions (10%). There were no malignant lesions. Ultrasound size had a Pearson correlation of 0.84 with pathologic size (P < 0.0001). There was no association between the size and final diagnosis. Conclusions: Over 9 y, all pediatric breast masses removed at a single center were benign, most commonly fibroadenoma. Ultrasound was an accurate predictor of size, but large lesions did not necessarily confer a high malignancy risk. Observation is appropriate for asymptomatic breast masses in children. Decision for surgery should be individualized and not based on size alone.
AB - Background: Pediatric breast masses can be a diagnostic challenge. Nearly all are benign, but there is no consensus on which should be removed. We hypothesized that children with asymptomatic breast lesions can be safely managed nonoperatively. Methods: We performed a single-institution retrospective review of children (≤18 y) who underwent breast mass excision from 2008 to 2016. Male patients with gynecomastia and those who had needle biopsy without formal excision were excluded. Pearson correlation was used to compare ultrasound and pathologic size. Kruskal–Wallis test was used to compare size and final diagnosis. Results: One hundred ninety-six patients were included (96% female). Mean age was 15 ± 3 y. Most patients (71%) presented with a painless mass. Preoperative ultrasound was obtained in 70%. Pathology included fibroadenoma (81.5%), tubular adenoma (5%), benign phyllodes tumor (3%), benign fibroepithelial neoplasm (0.5%), and other benign lesions (10%). There were no malignant lesions. Ultrasound size had a Pearson correlation of 0.84 with pathologic size (P < 0.0001). There was no association between the size and final diagnosis. Conclusions: Over 9 y, all pediatric breast masses removed at a single center were benign, most commonly fibroadenoma. Ultrasound was an accurate predictor of size, but large lesions did not necessarily confer a high malignancy risk. Observation is appropriate for asymptomatic breast masses in children. Decision for surgery should be individualized and not based on size alone.
KW - Breast mass
KW - Children
KW - Excision
KW - Fibroadenoma
KW - Observation
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U2 - 10.1016/j.jss.2018.03.056
DO - 10.1016/j.jss.2018.03.056
M3 - Article
C2 - 29907218
AN - SCOPUS:85045258730
VL - 228
SP - 247
EP - 252
JO - Journal of Surgical Research
JF - Journal of Surgical Research
SN - 0022-4804
ER -