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Surgical Treatment of Adolescent Breast Disorders: Institutional Experience and National Trends
Brittany L Murphy1, Amy E Glasgow2, Dan S Ubl2
1Department of General Surgery, Mayo Clinic, Rochester, Minnesota; The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.
Study Objective:
Adolescent breast disorders are rare and typically benign in nature; however, surgical treatments might require multiple surgeries. Because of the limited existing data, we sought to evaluate national trends and describe our institutional experience to help guide patient conversations.
Design:
Retrospective review.
Setting:
National database and academic institution.
Participants:
Patients 20 years old or younger who underwent a breast procedure in the Kids' Inpatient Database from January 2000 to December 2012 and at Mayo Clinic-Rochester from January 2000 to July 2016. Conditions were categorized into common and complex breast disorders.
Interventions:
None.
Main Outcome Measures:
To assess any trend of adolescent breast procedures across the United States as a whole, weighted Kids' Inpatient Database data were assessed using a Rao-Scott χ2 test. Within the institutional data, the average number of procedures needed to correct common vs complex breast disorders were compared using an unequal variance t test.
Results:
In recent years, the estimated number of hospitalizations for breast procedures decreased in the United States from 1661 in 2000 to 1078 in 2012 (P < .001). At our institution, 241 patients underwent a breast procedure (75.1% [181/241] female) over 16 years. Common breast disorders were corrected with fewer procedures than complex breast disorders (mean 1.09 vs 2.22 procedures; P = .0003).
Conclusion:
Inpatient treatment of adolescent breast disorders has been decreasing in recent years, likely reflecting a trend to outpatient procedures. Common adolescent breast disorders might be surgically corrected with 1 procedure, whereas complex disorders often require multiple surgeries to correct. It is important to discuss this with patients and their families to adequately set up expectations.
