Management of Pediatric Breast Masses: A Multi-institutional Retrospective Cohort Study.
Amy E Lawrence, Jacqueline Saito, Amanda Onwuka, Elissa Port, Alexis Bowder, Cathleen Courtney, Katherine J Deans, Cynthia D Downard, Yara K Duran, Mary E Fallat, Jason D Fraser, Samir Gadepalli, Rashmi Kabre, Elle L Kalbfell, Maria E Knaus, Jonathan Kohler, Dave Lal, Matthew P Landman, Charles M Leys, Patricia Lu, Grace Z Mak, Troy Markel, Naila Merchant, Tina Nguyen, Mercedes Pilkington, Beth Rymeski, Thomas T Sato, Shawn D St Peter, Tiffany Wright, Peter C Minneci, Julia E Grabowski
The Journal of surgical research 2021 AugThe objective of our study was to describe the workup, management, and outcomes of pediatric patients with breast masses undergoing operative intervention. 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. 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. 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. Copyright © 2021 Elsevier Inc. All rights reserved.
Citation
Amy E Lawrence, Jacqueline Saito, Amanda Onwuka, Elissa Port, Alexis Bowder, Cathleen Courtney, Katherine J Deans, Cynthia D Downard, Yara K Duran, Mary E Fallat, Jason D Fraser, Samir Gadepalli, Rashmi Kabre, Elle L Kalbfell, Maria E Knaus, Jonathan Kohler, Dave Lal, Matthew P Landman, Charles M Leys, Patricia Lu, Grace Z Mak, Troy Markel, Naila Merchant, Tina Nguyen, Mercedes Pilkington, Beth Rymeski, Thomas T Sato, Shawn D St Peter, Tiffany Wright, Peter C Minneci, Julia E Grabowski. Management of Pediatric Breast Masses: A Multi-institutional Retrospective Cohort Study. The Journal of surgical research. 2021 Aug;264:309-315
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PMID: 33845414
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