Giant breast tumours of adolescence.

The giant breast tumour of adolescence is rare in Caucasians. Six cases seen over 10 years are reported to illustrate diagnostic problems and highlight the importance of conservative management. Malignancy may be suspected because of rapid growth and skin ulceration. Conversely, the lesion may be considered to be no more than asymmetrical breast development or virginal hypertrophy. Clinical management problems have arisen because of confusion between fibroadenoma and the term cystosarcoma phylloides, previously used for tumours seen in older patients. The histological distinction between giant fibroadenoma and phylloides tumour has important clinical implications in older age groups. These implications do not apply to Caucasian adolescents in whom these tumours have a wide spectrum of histological appearances but uniformly benign clinical behaviour. Giant fibroadenoma of adolescence is a satisfactory designation and simple enucleation a satisfactory treatment, irrespective of the histological appearance.