Management of Pediatric Breast Masses: A Multi-institutional Retrospective Cohort Study

被引:4
|
作者
Lawrence, Amy E. [1 ,2 ]
Saito, Jacqueline [3 ]
Onwuka, Amanda [1 ]
Port, Elissa [4 ]
Bowder, Alexis [5 ]
Courtney, Cathleen [3 ]
Deans, Katherine J. [1 ,2 ]
Downard, Cynthia D. [7 ]
Duran, Yara K. [8 ]
Fallat, Mary E. [7 ]
Fraser, Jason D. [8 ]
Gadepalli, Samir [9 ]
Kabre, Rashmi [4 ]
Kalbfell, Elle L. [10 ]
Knaus, Maria E. [1 ,2 ]
Kohler, Jonathan [10 ]
Lal, Dave [5 ]
Landman, Matthew P. [6 ]
Leys, Charles M. [10 ]
Lu, Patricia [3 ]
Mak, Grace Z. [11 ]
Markel, Troy [6 ]
Merchant, Naila [12 ]
Nguyen, Tina [9 ]
Pilkington, Mercedes [9 ]
Rymeski, Beth [12 ]
Sato, Thomas T. [5 ]
St Peter, Shawn D. [8 ]
Wright, Tiffany [7 ]
Minneci, Peter C. [1 ,2 ]
Grabowski, Julia E. [4 ]
机构
[1] Nationwide Childrens Hosp, Ctr Surg Outcomes Res, Columbus, OH USA
[2] Ohio State Univ, Coll Med, Dept Surg, Nationwide Childrens Hosp,Div Pediat Surg, Columbus, OH 43210 USA
[3] Washington Univ, Sch Med, Dept Surg, Div Pediat Surg, St Louis, MO 63110 USA
[4] Northwestern Univ, Feinberg Sch Med, Div Pediat Surg, Dept Surg,Ann & Robert H Lurie Childrens Hosp Chi, Chicago, IL 60611 USA
[5] Med Coll Wisconsin, Dept Surg, Div Pediat Surg, 8700 W Wisconsin Ave, Milwaukee, WI 53226 USA
[6] Indiana Univ Sch Med, Div Pediat Surg, Dept Surg, Indianapolis, IN 46202 USA
[7] Univ Louisville, Sch Med, Dept Surg, Div Pediat Surg, Louisville, KY 40292 USA
[8] Childrens Mercy Hosp, Div Pediat Surg, Dept Surg, Kansas City, MO 64108 USA
[9] Univ Michigan, Dept Surg, Sect Pediat Surg, 1500 E Med Ctr Dr, Ann Arbor, MI 48109 USA
[10] Univ Wisconsin, Dept Surg, Sch Med & Publ Hlth, Div Pediat Surg, Madison, WI USA
[11] Univ Chicago Med & Biol Sci, Comer Childrens Hosp, Dept Surg, Sect Pediat Surg, Chicago, IL USA
[12] Cincinnati Childrens Hosp, Dept Pediat Surg, Cincinnati, OH USA
关键词
Breast masses; Fibroadenoma; BI-RADS; Phyllodes; CORE NEEDLE-BIOPSY; PHYLLODES TUMOR; LESIONS; DIAGNOSIS; ASPIRATION; RISK;
D O I
10.1016/j.jss.2021.01.041
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: The objective of our study was to describe the workup, management, and outcomes of pediatric patients with breast masses undergoing operative intervention. Materials and methods: 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. Results: 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. Conclusions: 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. (C) 2021 Elsevier Inc. All rights reserved.
引用
收藏
页码:309 / 315
页数:7
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