Abstract
Abstract
Objective
To describe the ultrasound evaluation and outcome of breast masses in a cohort of pubertal children.
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 was deemed positive 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
Two hundred forty patients (237 females) were included with a mean age of 17 years. The most common indication was a palpable mass (65%). Two hundred thirty-seven 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. Twenty-six patients with a positive ultrasound and without a biopsy underwent sonographic surveillance, 20 patients had unchanged findings, and 5 had decreased/resolved findings.
Conclusion
The prevalence of malignant pediatric breast masses is exceedingly low. No malignant breast masses were found in our cohort; however, diagnosis should be suspected based on the clinical presentation and ultrasound appearance. The low percentage of malignant breast masses suggests sonographic surveillance and patient education are feasible and safe management approaches in most adolescent breast mass cases.
Advances in knowledge
This study provides 1 of the largest analyses of adolescent breast ultrasounds, showing that malignancy is exceedingly rare and supporting sonographic surveillance as a safe management approach.