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

Amy E. Lawrence; Jacqueline Saito; Amanda Onwuka; Elissa Port; Alexis Bowder; Cathleen Courtney; Katherine J. Deans; Cynthia D. Downard; Yara K. Duran; Mary E. Fallat; Jason D. Fraser; Samir Gadepalli; Rashmi Kabre; Elle L. Kalbfell; Maria E. Knaus; Jonathan Kohler; Dave Lal; Matthew P. Landman; Charles M. Leys; Patricia Lu; Grace Z. Mak; Troy Markel; Naila Merchant; Tina Nguyen; Mercedes Pilkington; Beth Rymeski; Thomas T. Sato; Shawn D. St. Peter; Tiffany Wright; Peter C. Minneci; Julia E. Grabowski

doi:10.1016/j.jss.2021.01.041

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

Amy E. Lawrence, Jacqueline Saito, Amanda Onwuka, Elissa Port, Alexis Bowder, Cathleen Courtney, Katherine J. Deans, Cynthia D. Downard, Yara K. Duran, Mary E. Fallat, Jason D. Fraser, Samir Gadepalli, Rashmi Kabre, Elle L. Kalbfell, Maria E. Knaus, Jonathan Kohler, Dave Lal, Matthew P. Landman, Charles M. Leys, Patricia LuGrace Z. Mak, Troy Markel, Naila Merchant, Tina Nguyen, Mercedes Pilkington, Beth Rymeski, Thomas T. Sato, Shawn D. St. Peter, Tiffany Wright, Peter C. Minneci, Julia E. Grabowski

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2 Scopus citations

Abstract

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.

Original language	English
Pages (from-to)	309-315
Number of pages	7
Journal	Journal of Surgical Research
Volume	264
DOIs	https://doi.org/10.1016/j.jss.2021.01.041
State	Published - Aug 2021

Keywords

BI-RADS
Breast masses
Fibroadenoma
Phyllodes

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10.1016/j.jss.2021.01.041

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Lawrence, A. E., Saito, J., Onwuka, A., Port, E., Bowder, A., Courtney, C., Deans, K. J., Downard, C. D., Duran, Y. K., Fallat, M. E., Fraser, J. D., Gadepalli, S., Kabre, R., Kalbfell, E. L., Knaus, M. E., Kohler, J., Lal, D., Landman, M. P., Leys, C. M., ... Grabowski, J. E. (2021). Management of Pediatric Breast Masses: A Multi-institutional Retrospective Cohort Study. Journal of Surgical Research, 264, 309-315. https://doi.org/10.1016/j.jss.2021.01.041

@article{5ea3fc60c49043d395c1445e56773bc7,

title = "Management of Pediatric Breast Masses: A Multi-institutional Retrospective Cohort Study",

abstract = "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.",

keywords = "BI-RADS, Breast masses, Fibroadenoma, Phyllodes",

author = "Lawrence, {Amy E.} and Jacqueline Saito and Amanda Onwuka and Elissa Port and Alexis Bowder and Cathleen Courtney and Deans, {Katherine J.} and Downard, {Cynthia D.} and Duran, {Yara K.} and Fallat, {Mary E.} and Fraser, {Jason D.} and Samir Gadepalli and Rashmi Kabre and Kalbfell, {Elle L.} and Knaus, {Maria E.} and Jonathan Kohler and Dave Lal and Landman, {Matthew P.} and Leys, {Charles M.} and Patricia Lu and Mak, {Grace Z.} and Troy Markel and Naila Merchant and Tina Nguyen and Mercedes Pilkington and Beth Rymeski and Sato, {Thomas T.} and {St. Peter}, {Shawn D.} and Tiffany Wright and Minneci, {Peter C.} and Grabowski, {Julia E.}",

note = "Publisher Copyright: {\textcopyright} 2021 Elsevier Inc.",

year = "2021",

month = aug,

doi = "10.1016/j.jss.2021.01.041",

language = "English",

volume = "264",

pages = "309--315",

journal = "Journal of Surgical Research",

issn = "0022-4804",

}

Lawrence, AE, Saito, J, Onwuka, A, Port, E, Bowder, A, Courtney, C, Deans, KJ, Downard, CD, Duran, YK, Fallat, ME, Fraser, JD, Gadepalli, S, Kabre, R, Kalbfell, EL, Knaus, ME, Kohler, J, Lal, D, Landman, MP, Leys, CM, Lu, P, Mak, GZ, Markel, T, Merchant, N, Nguyen, T, Pilkington, M, Rymeski, B, Sato, TT, St. Peter, SD, Wright, T, Minneci, PC & Grabowski, JE 2021, 'Management of Pediatric Breast Masses: A Multi-institutional Retrospective Cohort Study', Journal of Surgical Research, vol. 264, pp. 309-315. https://doi.org/10.1016/j.jss.2021.01.041

TY - JOUR

T1 - Management of Pediatric Breast Masses

T2 - A Multi-institutional Retrospective Cohort Study

AU - Lawrence, Amy E.

AU - Saito, Jacqueline

AU - Onwuka, Amanda

AU - Port, Elissa

AU - Bowder, Alexis

AU - Courtney, Cathleen

AU - Deans, Katherine J.

AU - Downard, Cynthia D.

AU - Duran, Yara K.

AU - Fallat, Mary E.

AU - Fraser, Jason D.

AU - Gadepalli, Samir

AU - Kabre, Rashmi

AU - Kalbfell, Elle L.

AU - Knaus, Maria E.

AU - Kohler, Jonathan

AU - Lal, Dave

AU - Landman, Matthew P.

AU - Leys, Charles M.

AU - Lu, Patricia

AU - Mak, Grace Z.

AU - Markel, Troy

AU - Merchant, Naila

AU - Nguyen, Tina

AU - Pilkington, Mercedes

AU - Rymeski, Beth

AU - Sato, Thomas T.

AU - St. Peter, Shawn D.

AU - Wright, Tiffany

AU - Minneci, Peter C.

AU - Grabowski, Julia E.

PY - 2021/8

Y1 - 2021/8

N2 - 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.

AB - 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.

KW - BI-RADS

KW - Breast masses

KW - Fibroadenoma

KW - Phyllodes

UR - http://www.scopus.com/inward/record.url?scp=85103785616&partnerID=8YFLogxK

U2 - 10.1016/j.jss.2021.01.041

DO - 10.1016/j.jss.2021.01.041

M3 - Article

C2 - 33845414

AN - SCOPUS:85103785616

SN - 0022-4804

VL - 264

SP - 309

EP - 315

JO - Journal of Surgical Research

JF - Journal of Surgical Research

ER -

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

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Keywords

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