title: Breast disorders in girls and adolescents. Is there a need for a specialized service?
abstract: BACKGROUND
  Minor breast concerns in childhood and adolescence are common and lead to increased anxiety among young patients and their families, particularly due to high correlation with breast cancer. However, most breast services aim at managing adults and triaging patients with breast cancer, whereas adolescent medicine specialists or pediatricians are usually not appropriately trained to identify and treat breast pathology.
  
  
  METHODS
  We reviewed hospital records of all patients attending a pediatric and adolescent gynecology or breast clinic of a tertiary referral hospital, with a breast related symptom, between January 2009 and December 2011. We collected information regarding age at presentation, age at menarche, diagnosis, management and outcome.
  
  
  RESULTS
  We identified 81 patients of which 11 presented with an abnormal nipple or areolar secretion, 33 had a palpable lump, 20 had mastitis, and 16 had unequal breast development. One patient presented with virginal breast hypertrophy. Three out of 11 of the patients with an abnormal secretion had a cyst identified on ultrasonography. Out of the palpable lumps 12 were fibroadenomas, 3 were phyllodes tumors, and 14 were cystic in nature. The phyllodes tumors and half of the fibroadenomas were removed. The remaining fibroadenomas remain under regular ultrasonographic follow-up. All cases of mastitis were treated conservatively and resolved with broad spectrum antibiotic treatment.
  
  
  CONCLUSIONS
  In our series, no malignancies were identified. Although 8 patients required surgical treatment, the majority of cases were treated conservatively.
authors: 1(st)Department of Obstetrics and Gynaecology, University of Athens, Alexandra Hospital, Athens, Greece. Electronic address: linamichalas@hotmail.com.
authors: Lina
authors: L
authors: Michala
authors: 1(st)Department of Obstetrics and Gynaecology, University of Athens, Alexandra Hospital, Athens, Greece.
authors: Alexandra
authors: A
authors: Tsigginou
authors: 1(st)Department of Obstetrics and Gynaecology, University of Athens, Alexandra Hospital, Athens, Greece.
authors: Dimitris
authors: D
authors: Zacharakis
authors: 1(st)Department of Obstetrics and Gynaecology, University of Athens, Alexandra Hospital, Athens, Greece.
authors: Constantine
authors: C
authors: Dimitrakakis
mesh_terms: D000293:Adolescent; D000295:Adolescent Medicine; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D012189:Retrospective Studies; D062606:Tertiary Care Centers
keywords: Adolescent breast; Breast discharge; Fibroadenomas; Mastitis