Related Experiment Video
Updated: Jun 13, 2026
Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition
Published on: June 21, 2024
Breast fibroadenomas in the pediatric population: common and uncommon sonographic findings
Ramon Sanchez1, Maria F Ladino-Torres, John A Bernat
1Section of Pediatric Radiology, Department of Radiology, C. S. Mott Children's Hospital, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-5252, USA. ramonsan@umich.edu
Insights
Pediatric breast fibroadenomas are common solid masses in girls, typically appearing oval and hypoechoic on ultrasound. Radiologists should recognize characteristic findings to avoid unnecessary biopsies, as malignancy is rare.
Area of Science:
- Pediatric Radiology
- Breast Imaging
- Oncology
Background:
- Sonography is crucial for evaluating pediatric breast lumps, with fibroadenomas being the most common diagnosis.
- Familiarity with fibroadenoma sonographic findings aids diagnosis and prevents unnecessary procedures.
Purpose of the Study:
- To characterize the spectrum of sonographic appearances of pathologically confirmed pediatric breast fibroadenomas.
Main Methods:
- Retrospective review of breast ultrasound (US) examinations from January 2001 to June 2009 for patients under 19.
- Analysis of 49 pathologically proven breast masses in 43 children, focusing on 44 fibroadenomas.
- Characterization of US findings including size, shape, echogenicity, margins, and vascularity.
Main Results:
- Fibroadenomas constituted 91% of pathologically proven solid pediatric breast masses.
- Common US findings: oval shape, hypoechoic echogenicity, posterior acoustic enhancement, internal Doppler signal.
- Lobulations (57%) were common; absent vascular flow, complex echoes, isoechoic patterns, posterior shadowing, and angular margins were less frequent or rare.
Conclusions:
- Pediatric breast fibroadenomas are the most frequent solid masses in girls, with sonographic features similar to adults.
- Radiologists must be aware of typical and atypical fibroadenoma appearances to minimize unnecessary biopsies, given the rarity of pediatric breast malignancy.
Background:
Sonography is usually requested to evaluate palpable pediatric breast lumps, and solid masses are almost always fibroadenomas. Lack of familiarity with the findings of fibroadenomas can lead to diagnostic uncertainty and sometimes unnecessary biopsy and excision. We sought to review the spectrum of sonographic findings in our cases of pathology proven pediatric fibroadenomas.
Objective:
The purpose of this retrospective study was to describe the sonographic appearances of pathologically proven pediatric breast fibroadenomas.
Materials And Methods:
A query of the Department of Radiology database at our institution was performed for all patients younger than 19 years who underwent breast US from January 2001 to June 2009. A total of 332 patients were identified: 282 girls (85%) and 50 boys (15%). Ninety-one girls and no boys had a solid breast mass based on US findings. Forty-three children had a total of 49 pathologically proven breast masses with the diagnoses of fibroadenoma (44), hamartoma (1), non-Hodgkin lymphoma (1), tubular adenoma (1), pseudoangiomatous stromal hyperplasia (1) and lactation changes (1). Reviews of medical records, histological results and sonographic examinations of all pathology-proven fibroadenomas were performed. US findings were characterized according to location, multiplicity, size, shape, echogenicity and homogeneity, definition of margins, posterior acoustic features and Doppler vascularity.
Results:
The vast majority of solid breast masses in girls are histologically benign. Fibroadenomas accounted for 91% of the pathologically proven solid breast masses. Common findings on US imaging are an oval shape, hypoechoic echo pattern, posterior acoustic enhancement and internal Doppler signal. Lobulations were found in 57% of the masses. Less common findings are absent internal vascular flow and complex echo pattern, while isoechoic echo pattern, posterior shadowing and angular margins are rare or unusual.
Conclusion:
Fibroadenomas represent the most common solid mass in the breasts of girls. Sonographic appearances are usually characteristic and do not significantly differ from those found in adults. The radiologist must be aware of common and uncommon sonographic appearances of fibroadenomas in the pediatric age group and should be cautious when recommending histological confirmation based on imaging findings, as breast malignancy is extremely rare.
