Breast Lesions in Children and Adolescents: Diagnosis and Management

Area of Science:

• Radiology
• Pediatric Oncology
• Breast Imaging

Background:

• Pediatric breast disease is uncommon, with primary breast carcinoma in children being extremely rare.
• Diagnostic and management approaches for pediatric breast lesions differ significantly from adult protocols.
• Understanding normal developmental imaging and disease characteristics is crucial for accurate diagnosis.

Purpose of the Study:

• To outline the diagnostic and management strategies for breast lesions in pediatric patients.
• To emphasize the importance of imaging in differentiating benign from malignant pediatric breast conditions.
• To provide guidance on the appropriate use of interventional procedures, including biopsy, in children.

Main Methods:

• Review of imaging features of normal breast development and common pediatric breast diseases.
• Correlation of imaging findings with clinical history and histologic examination.
• Criteria for recommending core needle biopsy in pediatric breast lesions based on imaging and clinical risk factors.

Main Results:

• Most pediatric breast diseases are benign or related to development, favoring conservative treatment.
• Core needle biopsy is a valuable tool for accurate diagnosis and avoiding irreparable damage in pediatric patients.
• Biopsy is indicated for lesions with abnormal imaging features (e.g., non-circumscribed margins, >3 cm size) or specific risk factors for malignancy.

Conclusions:

• Accurate diagnosis and appropriate management of pediatric breast lesions require specialized knowledge of developmental imaging and disease patterns.
• Conservative management is often appropriate for benign pediatric breast conditions.
• Core needle biopsy is essential for definitive diagnosis in cases with suspicious imaging or risk factors, guiding treatment and preventing harm.