Frequency of breast lesions in pubertal children with ultrasound evaluation

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Abstract

BACKGROUND : Breast masses in the puberal children are uncommon. Ultrasound is the first modality of choice to evaluate for breast masses in children. OBJECTIVE: To evaluate the frequency and etiology of breast masses in puberal children with ultrasound. METHODS: A single institution, institutional review board–approved, retrospective study was performed including 13- to 18-year-old patients who had a breast ultrasound from January 1990 to December 2024. Clinical information and the ultrasound results were collected. Ultrasound were considered positive or negative if it explained the patients concern. Tissue sample was determined by the patient and ordering physician. Pathology results and follow-up ultrasounds were recorded as well. Descriptive analysis was performed. RESULTS : 240 patients (237 girls) were included with a mean age of 13 years. The most common indication was a palpable mass (65%). 237 ultrasounds were positive (99%), 193 patients had a biopsy (80%). The most common diagnoses were fibroadenoma (69%), hamartoma (13%), and phyllodes tumor (7%). No primary or secondary breast malignancies were identified. 26 patients with a positive ultrasound and without a biopsy underwent sonographic surveillance, 20 patient had unchanged findings and 5 had decreased/resolved findings. CONCLUSION : The prevalence of malignant pediatric breast masses is exceedingly low. Lesions with the potential to be malignant are uncommon, and diagnosis should be suspected based on the clinical presentation and ultrasound appearance. Sonographic surveillance and patient education are feasible and safe management approaches in most adolescent breast mass cases.

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