title: Transaxillary Subcutaneouscopic Excision of Fibroadenoma of the Breast in Children: The Covert Scar Approach.
abstract: BACKGROUND
  Fibroadenoma is a common condition in adolescent girls. Most tumors are excised either through a periareolar approach or the inframammary approach. Both approaches produce visible scars in adolescent girls. We propose a new cosmetic approach to this lesion and report our experience with the transaxillary subcutaneouscopic approach for excision of the fibroadenoma of the breast. The purpose of this case report is to delineate an innovative surgical approach to resection of a breast fibroadenoma that yields an adequate resection without possible damage to the ductal system while optimizing cosmetic results by avoiding scars.
  
  
  METHODS
  We retrospectively reviewed the medical records of four adolescent girls who underwent the above approach for excision of fibroadenoma of the breast. The age range was 14-16 years.
  
  
  RESULTS
  There were no complications in all 4 patients. The final result at the 3-month follow-up revealed an esthetically pleasing skin incision that healed well and was hidden by the natural skin fold of the axilla.
  
  
  CONCLUSIONS
  Transaxillary subcutaneouscopic excision of fibroadenoma of the breast in children is a safe and effective technique and should be considered for excision of benign breast lesions in children.
authors.affiliation: Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine and Texas Children's Hospital , Houston, Texas.
authors.forename: Mirtha
authors.initials: M
authors.lastname: Gonzalez
authors.affiliation: Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine and Texas Children's Hospital , Houston, Texas.
authors.forename: Ashwin
authors.initials: A
authors.lastname: Pimpalwar
mesh_terms: D000293:Adolescent; D001365:Axilla / Q000601:surgery*; D001943:Breast Neoplasms / Q000601:surgery*; D002921:Cicatrix / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D018226:Fibroadenoma / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D016896:Treatment Outcome