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Outcomes of a joint paediatric breast clinic: an observational case series
Nasib Alchoikani1,2, Michaela Stahnke1, Michael Stanton1
1University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Insights
This study found no malignant breast lesions in female pediatric patients. Most patients with breast lumps had benign conditions like fibroadenoma, with few requiring surgery.
Area of Science:
- Pediatric Surgery
- Oncology
- Breast Health
Background:
- Female pediatric patients with breast symptoms often see various specialists.
- Limited evidence exists to guide diagnosis and treatment for pediatric breast conditions.
Purpose of the Study:
- To describe the spectrum of symptoms, diagnoses, and outcomes in female pediatric patients presenting with breast-related symptoms.
- To evaluate the effectiveness of a joint pediatric breast clinic model.
Main Methods:
- Retrospective review of clinical records for female patients under 18 years old seen between December 2017 and December 2023.
- Analysis of symptoms, investigations, interventions, outcomes, and histological diagnoses.
Main Results:
- 152 patients were included; 116 presented with breast lumps and 36 with other symptoms.
- Common diagnoses included normal breast tissue (45%) and fibroadenoma (35%). No malignant lesions were found.
- Surgery was performed in 15% of patients with breast lumps, all confirmed benign.
Conclusions:
- The joint clinic model effectively managed pediatric breast conditions and identified non-breast related symptoms.
- Collaboration between pediatricians and breast surgeons is crucial for optimal patient care.
Objective:
Female paediatric patients with breast symptoms may see a range of specialists with varying expertise and experience in managing their condition. There is a paucity of evidence to guide diagnosis and treatment. We report our joint paediatric breast clinic experience to describe the spectrum of symptoms and outcomes, with follow-up, in female paediatric patients presenting with breast-related symptoms.
Method:
A retrospective review of clinical records of all females (<18 years) seen between December 2017 and December 2023 in a joint paediatric/surgical breast clinic was conducted. Symptoms, investigations, interventions, outcomes and histological diagnoses were reviewed.
Results:
152 patients were included: 116 (76.3%) with breast lump-related symptoms (group A) and 36 (23.7%) with other non-lump breast-related symptoms (group B).In group A, 112/116 (97%) patients underwent ultrasound evaluation. The most common diagnoses were normal breast tissue (52; 45%) and fibroadenoma (FA) (40; 35%). 13 (11%) patients underwent excision for presumed FA, all confirmed benign FA with no complications. Another eight (7%) patients re-presented after discharge; four had excision, all benign FAs.In group B, the most common clinical diagnosis was breast asymmetry 17/36 (47%). Two patients re-presented, with one having a diagnosis of FA supported by fine needle aspiration.Overall, 22 (15%) patients required onward referral/investigations for symptoms unrelated to their breast symptoms.
Conclusion:
No malignant lesion was diagnosed in this cohort of patients, and surgery was performed in 15% of those presenting with a breast lump. Paediatrician and breast surgeon collaboration facilitated the identification and referral of non-breast symptoms, supporting adoption of this model.
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