title: Analysis of surgically excised breast masses in 119 pediatric patients.
abstract: OBJECTIVE
  Breast masses in children and adolescents are uncommon and the vast majority are benign. There are currently limited analyses of breast masses in this population and clinical management is highly variable between institutions and providers. The purpose of our study is to analyze the demographics, pathology and management of 119 pediatric patients with breast masses; one of the largest studies to date.
  
  
  METHODS
  We performed a retrospective review of patients who underwent excision of a breast mass at a single pediatric center from June 2009 to November 2013. Demographics, imaging, pathology and management were reviewed.
  
  
  RESULTS
  Average patient age was 15.3 years, average mass size was 3.15 cm and 20.3 % had a family history of breast cancer. 68 % of patients had pre-operative ultrasound, and 31.9 % underwent a period of observation. The most common indication for resection was patient and family anxiety. All masses were benign, with fibroadenoma being the most common histopathology (75.2 %).
  
  
  CONCLUSIONS
  In our cohort there were no cases of malignancy. Only 31.9 % of patients underwent some form of observation and patient or family anxiety was the most common indication for proceeding with surgery. This suggests that patient anxiety may result in unnecessary operation. Our data may help reassure patients, families and providers that the risk of malignancy is low and could help develop more optimal management strategies.
authors.affiliation: Department of General Surgery, Brigham and Women's Hospital, Boston, MA, USA. jknell1@partners.org.
authors.forename: Jamie
authors.initials: J
authors.lastname: Knell
authors.affiliation: Department of Radiology, University of California San Diego, La Jolla, CA, USA.
authors.forename: Jeffery L
authors.initials: JL
authors.lastname: Koning
authors.affiliation: Department of Pediatric Surgery, Ann and Robert Lurie Children's Hospital of Chicago, Chicago, IL, USA.
authors.forename: Julia E
authors.initials: JE
authors.lastname: Grabowski
mesh_terms: D000293:Adolescent; D001940:Breast / Q000601:surgery; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D018226:Fibroadenoma / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult
keywords: Breast mass; Excisional biopsy; Fibroadenoma; Ultrasound