What is the role of ultrasonography (US) in the workup of pediatric breast masses?

Updated: Feb 01, 2017
  • Author: Paul R Fisher, MD; Chief Editor: Eugene C Lin, MD  more...
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US is particularly helpful in characterizing cystic, inflammatory, and neoplastic lesions in children. Fibroadenomas are the most common breast tumors in adolescent girls and may become large. Although most masses that occur in the pediatric breast are benign, phyllodes tumors may be benign or malignant. In adolescents, cystosarcoma phyllodes are rare, but they are still the most common malignant breast tumors. Phyllodes tumors are usually well-circumscribed, oval, or lobulated tumors, and they may have cystic areas. In a study involving female adolescents, Kronemer et al found that sonograms demonstrated 36 fibroadenomas, 12 cysts, 7 abscesses, 1 lactating adenoma, and 1 phyllodes tumor. [83]

After using US to evaluate breast masses in pediatric and adolescent patients, Weinstein et al reported findings on gynecomastia, cyst, fibroadenoma, lymph node, galactocele, duct ectasia, and infection. [9] They had no patients with malignancy, but they cautioned that, in rare cases, rhabdomyosarcoma, non-Hodgkin lymphoma, and leukemia may metastasize to the breast; they also reported that in patients of this age group, these diseases are more likely to be found than a primary breast cancer.

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