Pediatric and Adolescent Surgical Breast Clinic: Preliminary Experience

Abstract

Study objective: The diagnostic and treatment tools used in breast centers are largely geared to adults, and there is little consideration of the unique characteristics of breast diseases in younger age groups. Herein we report on the preliminary experience of a specialized breast clinic for children and adolescents.

Design: Retrospective, observational.

Setting: Pediatric Surgical Breast Clinic of Schneider Children's Medical Center of Israel.

Participants: Patients referred to the clinic during the first 18 months of its establishment.

Interventions and main outcome measures: Rate of breast masses, rate of malignancy, and types of evaluation and treatment.

Results: Forty-seven patients aged 0-19 years were referred. Breast masses were suspected in 23/47 (48.9%) and confirmed using ultrasound in 14/47 (29.7%; mean age, 16.4 years), followed by needle core biopsy in 7. Seven patients had multiple masses. Breast Imaging and Reporting Data System scores ranged from 3 to 4b. All cases were treated as fibroadenomas. Four patients underwent surgery because of a large mass (>5 cm; n = 3) or patient's preference to remove the lump rather than follow-up (n = 1). There were no malignancies. The median time from patient identification of the mass until seeking medical help was 5 months.

Conclusion: Several findings distinct to this age group were highlighted: high rate of multiple masses, lack of malignancy, and high risk of delayed diagnosis. Care should be taken when using Breast Imaging and Reporting Data System categorization because it was formulated for adults and might be very limited in the adolescent population. Longer-term studies of larger cohorts are planned.

Keywords: Adolescent; BI-RADS; Breast clinic; Breast mass; Fibroadenoma.