The limited role of ultrasound in the surgical assessment of solid pediatric breast lesions

• Published in: Clinical imaging Vol. 74; pp. 100 - 105
• Main Authors: Granger, Caroline J., Hogan, Anthony R., Neville, Holly L., Thorson, Chad M., Perez, Eduardo A., Sola, Juan E., Brady, Ann-Christina
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2021; Elsevier Limited
• Subjects: Accuracy; Aged; Breast; Breast cancer; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - surgery; Child; Clinical examination; Decision making; Diameters; Fibroadenoma; Humans; Lesions; Medical records; Pathology; Patients; Pediatric breast mass; Pediatrics; Phyllodes Tumor; Population; Reliability analysis; Reproducibility of Results; Retrospective Studies; Statistical analysis; Surgery; Surgical outcomes; Tumors; Ultrasonic imaging; Ultrasonography; Ultrasound; P; CE; Pediatric breast mass; Fibroadenoma; Clinical examination; Ultrasound; US
• ISSN: 0899-7071; 1873-4499
• DOI: 10.1016/j.clinimag.2020.12.042

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). A single institutional retrospective analysis of patients aged ≤18 years who underwent breast mass resection was performed. Data was collected and analyzed using SPSS. 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. 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. •Ultrasound and clinical exam reliably estimate the size of pediatric breast lesions.•Ultrasound is no better than clinical exam at predicting mass size.•Pediatric breast mass size is a common indication for surgery.•Clinical exam should be used over ultrasound for surgical pediatric breast masses.