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Approach to Pediatric Breast Masses in Accompaniment with Current Literature. JOURNAL OF CONTEMPORARY MEDICINE 2022. [DOI: 10.16899/jcm.930896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Singh S, Gaur K, Puri A. Mammary Fibrocystic Change in a Pre-Pubertal child- A Case Report with a Histopathological Perspective. Fetal Pediatr Pathol 2021; 40:535-539. [PMID: 32075463 DOI: 10.1080/15513815.2020.1721739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Fibrocystic change in the breast is one of the entities under the spectrum of benign breast disease. It occurs primarily in females of the reproductive age group. Though the exact etiology is unknown, estrogen-progesterone imbalance is possibly one of the causative factors. Its occurrence in the pediatric age group is infrequent and is hitherto unreported in the pre-pubertal age group. Case report: We present the case of a 2-year-old female presenting with an ill -defined lump approximately 4 cm in diameter, with an unremarkable hormonal status for the age. Histopathology revealed fibrocystic change in the resected tissue. Conclusion: Fibrocystic breast change in children may represent an exaggeration of the normal developmental involution process.
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Affiliation(s)
- Smita Singh
- Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Kavita Gaur
- Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Archana Puri
- Pediatric Surgery, Lady Hardinge Medical College, New Delhi, India
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D'Auria D, Ferrara D, Aragione N, De Chiara C, Argenziano G, Noschese I, Noviello D, Esposito F. Role of ultrasound in diagnosis of neonatal breast enlargement: a newborn case report. Radiol Case Rep 2021; 16:2692-2696. [PMID: 34336074 PMCID: PMC8318999 DOI: 10.1016/j.radcr.2021.06.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 06/20/2021] [Indexed: 11/21/2022] Open
Abstract
Neonatal breast enlargement is a hormone-related condition, mostly asymptomatic\physiological, with a well-recognizable sonographic appearance but limited data in the literature. It can be uni-or bilateral. Typically described in the first week of life, the transient lesion disappears spontaneously within 6 months. The main differential diagnosis is neonatal mastitis, a breast tissue infection that requires a specific antibiotic therapy. Knowledge of clinical and imaging findings is crucial, and ultrasound represents a reliable tool which allows a quick identification and an excellent examination of neonatal breast abnormalities. We aim to highlight sonographic classic features of benign neonatal breast enlargement showing how ultrasound rules out real breast masses helping to differentiate between it and mastitis when clinical and laboratory data are inconclusive. We describe a 2-day-old male with bilateral breast swelling more pronounced on the right side.
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Affiliation(s)
- Divina D'Auria
- Department of Advanced Biomedical Sciences, Federico II University Unina, Via Sergio Pansini, Naples, Italy
- Corresponding author.
| | - Dolores Ferrara
- U.O. Radiology, A.O.R.N. Santobono-Pausilipon Children Hospital, Via Mario Fiore, Naples, Italy
| | - Nunzia Aragione
- Department of Neonatal Pathology, A.O.R.N. Santobono-Pausilipon Children Hospital, Via Mario Fiore, Naples, Italy
| | - Carolina De Chiara
- Department of Neonatal Pathology, A.O.R.N. Santobono-Pausilipon Children Hospital, Via Mario Fiore, Naples, Italy
| | - Gioconda Argenziano
- U.O. Radiology, A.O.R.N. Santobono-Pausilipon Children Hospital, Via Mario Fiore, Naples, Italy
| | - Ivan Noschese
- Department of Advanced Biomedical Sciences, Federico II University Unina, Via Sergio Pansini, Naples, Italy
| | - Domenico Noviello
- U.O. Radiology, A.O.R.N. Santobono-Pausilipon Children Hospital, Via Mario Fiore, Naples, Italy
| | - Francesco Esposito
- U.O. Emergency Radiology, A.O.R.N. Santobono-Pausilipon Children Hospital, Via Mario Fiore, Naples, Italy
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Granger CJ, Hogan AR, Neville HL, Thorson CM, Perez EA, Sola JE, Brady AC. The limited role of ultrasound in the surgical assessment of solid pediatric breast lesions. Clin Imaging 2021; 74:100-105. [PMID: 33465666 DOI: 10.1016/j.clinimag.2020.12.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/28/2020] [Accepted: 12/31/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Ultrasound (US) is an adjunct to history and clinical exam (CE) in the assessment of pediatric breast lesions. We sought to investigate the reliability of US and CE to predict final pathologic diameter (P). METHODS A single institutional retrospective analysis of patients aged ≤18 years who underwent breast mass resection was performed. Data was collected and analyzed using SPSS. RESULTS 88 patients met inclusion criteria with an average age at surgery of 16 ± 1.5 years. No malignancies were encountered. The largest mean diameter measured by final pathology (MPØ) for all lesions was 4.1 ± 2.6 cm. Pathology encountered were fibroadenoma (83%, MPØ 3.7 ± 1.7 cm), juvenile fibroadenoma (10%, MPØ 7.0 ± 5.4 cm), and low-grade phyllodes tumor (3%, MPØ 6.2 ± 3.8 cm). 67 patients had documented CE measurement with a mean diameter of 3.4 ± 1.8 cm. 62 patients underwent US with a mean diameter of 3.3 ± 1.6 cm. US and CE were accurate in determining P by Cronbach Alpha reliability testing. CONCLUSION US and CE are reliable measurements of P. The surgical utility of US when considering pediatric breast lesions is limited and should be individualized following pediatric surgical evaluation and CE.
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Affiliation(s)
- Caroline J Granger
- Leonard M. Miller School of Medicine, University of Miami, 1600 NW 10th Ave, Suite 1140, Miami, FL 33136, USA
| | - Anthony R Hogan
- Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 450, Miami, FL 33136, USA
| | - Holly L Neville
- Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 450, Miami, FL 33136, USA
| | - Chad M Thorson
- Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 450, Miami, FL 33136, USA
| | - Eduardo A Perez
- Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 450, Miami, FL 33136, USA
| | - Juan E Sola
- Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 450, Miami, FL 33136, USA
| | - Ann-Christina Brady
- Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 450, Miami, FL 33136, USA.
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Abstract
<br><b>Introduction:</b> Fibroadenomas are one of the most common benign tumors of the breast in the adolescent females accounting for about 2/3<sup>rd</sup> of all the breast lumps and more than half of all the biopsied breast lesions. They come into being due to overgrowth of glandular tissue under the influence of hormonal changes that the girls undergo at the time of puberty. Due to the wide prevalence of fibroadenomas and the psychosocial morbidity associated with the finding of a breast mass, it is imperative for physicians treating adolescent patients to be thoroughly familiar and updated with this disease. <br><b>Aim:</b> The article aims at providing a brief review of the classification, presentation, diagnosis, and update on the management of breast fibroadenomas on the basis of recent literature.
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Lee EJ, Chang YW, Oh JH, Hwang J, Hong SS, Kim HJ. Breast Lesions in Children and Adolescents: Diagnosis and Management. Korean J Radiol 2018; 19:978-991. [PMID: 30174488 PMCID: PMC6082765 DOI: 10.3348/kjr.2018.19.5.978] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/04/2018] [Indexed: 11/15/2022] Open
Abstract
Pediatric breast disease is uncommon, and primary breast carcinoma in children is extremely rare. Therefore, the approach used to address breast lesions in pediatric patients differs from that in adults in many ways. Knowledge of the normal imaging features at various stages of development and the characteristics of breast disease in the pediatric population can help the radiologist to make confident diagnoses and manage patients appropriately. Most breast diseases in children are benign or associated with breast development, suggesting a need for conservative treatment. Interventional procedures might affect the developing breast and are only indicated in a limited number of cases. Histologic examination should be performed in pediatric patients, taking into account the size of the lesion and clinical history together with the imaging findings. A core needle biopsy is useful for accurate diagnosis and avoidance of irreparable damage in pediatric patients. Biopsy should be considered in the event of abnormal imaging findings, such as non-circumscribed margins, complex solid and cystic components, posterior acoustic shadowing, size above 3 cm, or an increase in mass size. A clinical history that includes a risk factor for malignancy, such as prior chest irradiation, known concurrent cancer not involving the breast, or family history of breast cancer, should prompt consideration of biopsy even if the lesion has a probably benign appearance on ultrasonography.
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Affiliation(s)
- Eun Ji Lee
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
| | - Yun-Woo Chang
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
| | - Jung Hee Oh
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
| | - Jiyoung Hwang
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
| | - Seong Sook Hong
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
| | - Hyun-Joo Kim
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea
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