Characterizing excised breast masses in children and adolescents—Can a more aggressive pathology be predicted?

Purpose: Our aim was to characterize excised breast masses in children and adolescent and to identify factors associated with a more aggressive pathology. Methods: Retrospective review of all female patients < 19 who underwent excision of breast masses at our institution between 1999 and 2018. Demographic, clinical, imaging, pathological and management data were collected. We assessed possible association of any of the variables with a more aggressive pathology (phyllodes tumor and malignancy). Correlation between core needle biopsy results and final pathology results was also calculated. Results: 70 patients were included. Median age was 17 years (range: 11–19). Resected mass size was 4 cm (range: 2–16). Final pathology results were: fibroadenoma (49), juvenile fibroadenoma (7), hamartoma (5), benign phyllodes (7), malignant phyllodes (1) and sarcoma (1). Pathology was benign in 61 (87%) patients and more aggressive (phyllodes and sarcoma) in 9 (13%). None of the tested variables was associated with a more aggressive pathology. Presurgical core biopsy results matched final pathology in only 63.6%. Conclusions: Excised breast masses in children and adolescents are sometimes of a more aggressive pathology, which cannot be predicted by presurgical factors, including a core needle biopsy. Prognosis study Level of evidence: III.