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119例儿科患者手术切除乳腺肿块的分析。

Analysis of surgically excised breast masses in 119 pediatric patients.

作者信息

Knell Jamie, Koning Jeffery L, Grabowski Julia E

机构信息

Department of General Surgery, Brigham and Women's Hospital, Boston, MA, USA.

Department of Radiology, University of California San Diego, La Jolla, CA, USA.

出版信息

Pediatr Surg Int. 2016 Jan;32(1):93-6. doi: 10.1007/s00383-015-3818-5. Epub 2015 Nov 20.

Abstract

PURPOSE

Breast masses in children and adolescents are uncommon and the vast majority are benign. There are currently limited analyses of breast masses in this population and clinical management is highly variable between institutions and providers. The purpose of our study is to analyze the demographics, pathology and management of 119 pediatric patients with breast masses; one of the largest studies to date.

METHODS

We performed a retrospective review of patients who underwent excision of a breast mass at a single pediatric center from June 2009 to November 2013. Demographics, imaging, pathology and management were reviewed.

RESULTS

Average patient age was 15.3 years, average mass size was 3.15 cm and 20.3 % had a family history of breast cancer. 68 % of patients had pre-operative ultrasound, and 31.9 % underwent a period of observation. The most common indication for resection was patient and family anxiety. All masses were benign, with fibroadenoma being the most common histopathology (75.2 %).

CONCLUSIONS

In our cohort there were no cases of malignancy. Only 31.9 % of patients underwent some form of observation and patient or family anxiety was the most common indication for proceeding with surgery. This suggests that patient anxiety may result in unnecessary operation. Our data may help reassure patients, families and providers that the risk of malignancy is low and could help develop more optimal management strategies.

摘要

目的

儿童和青少年乳腺肿块并不常见,绝大多数为良性。目前针对该人群乳腺肿块的分析有限,各机构和医生之间的临床管理差异很大。我们研究的目的是分析119例患有乳腺肿块的儿科患者的人口统计学、病理学及治疗情况;这是迄今为止规模最大的研究之一。

方法

我们对2009年6月至2013年11月在一家儿科中心接受乳腺肿块切除术的患者进行了回顾性研究。回顾了患者的人口统计学、影像学、病理学及治疗情况。

结果

患者平均年龄为15.3岁,肿块平均大小为3.15厘米,20.3%的患者有乳腺癌家族史。68%的患者术前行超声检查,31.9%的患者接受了一段时间的观察。最常见的切除指征是患者及家属焦虑。所有肿块均为良性,纤维腺瘤是最常见的组织病理学类型(75.2%)。

结论

在我们的队列中没有恶性肿瘤病例。只有31.9%的患者接受了某种形式的观察,患者或家属焦虑是进行手术最常见的指征。这表明患者焦虑可能导致不必要的手术。我们的数据可能有助于让患者、家属和医生放心,恶性肿瘤风险较低,并有助于制定更优化的管理策略。

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