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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
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.