Cohen Osher, Avinadav Efrat, Sharon Eran, Pirogovsky Avinoam, Freud Enrique
Departments of Pediatric and Adolescent Surgery, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Departments of Pediatric and Adolescent Surgery, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Pediatr Adolesc Gynecol. 2020 Feb;33(1):23-26. doi: 10.1016/j.jpag.2019.08.010. Epub 2019 Aug 21.
The diagnostic and treatment tools used in breast centers are largely geared to adults, and there is little consideration of the unique characteristics of breast diseases in younger age groups. Herein we report on the preliminary experience of a specialized breast clinic for children and adolescents.
Retrospective, observational.
Pediatric Surgical Breast Clinic of Schneider Children's Medical Center of Israel.
Patients referred to the clinic during the first 18 months of its establishment.
Rate of breast masses, rate of malignancy, and types of evaluation and treatment.
Forty-seven patients aged 0-19 years were referred. Breast masses were suspected in 23/47 (48.9%) and confirmed using ultrasound in 14/47 (29.7%; mean age, 16.4 years), followed by needle core biopsy in 7. Seven patients had multiple masses. Breast Imaging and Reporting Data System scores ranged from 3 to 4b. All cases were treated as fibroadenomas. Four patients underwent surgery because of a large mass (>5 cm; n = 3) or patient's preference to remove the lump rather than follow-up (n = 1). There were no malignancies. The median time from patient identification of the mass until seeking medical help was 5 months.
Several findings distinct to this age group were highlighted: high rate of multiple masses, lack of malignancy, and high risk of delayed diagnosis. Care should be taken when using Breast Imaging and Reporting Data System categorization because it was formulated for adults and might be very limited in the adolescent population. Longer-term studies of larger cohorts are planned.
乳腺中心所使用的诊断和治疗工具主要针对成年人，很少考虑年轻年龄组乳腺疾病的独特特征。在此，我们报告一家儿童和青少年专科乳腺诊所的初步经验。
回顾性观察研究。
以色列施耐德儿童医疗中心儿科外科乳腺诊所。
诊所成立后的前18个月内转诊至该诊所的患者。
乳腺肿块发生率、恶性肿瘤发生率以及评估和治疗类型。
共转诊了47例年龄在0至19岁的患者。47例中有23例（48.9%）怀疑有乳腺肿块，其中14例（29.7%；平均年龄16.4岁）经超声确诊，随后7例行粗针穿刺活检。7例患者有多个肿块。乳腺影像报告和数据系统（BI-RADS）评分范围为3至4b。所有病例均按纤维腺瘤治疗。4例患者因肿块较大（>5 cm；n = 3）或患者更倾向于切除肿块而非随访（n = 1）而接受了手术。未发现恶性肿瘤。从患者发现肿块到寻求医疗帮助的中位时间为5个月。
突出了该年龄组的几个独特发现：多个肿块发生率高、无恶性肿瘤以及延迟诊断风险高。使用乳腺影像报告和数据系统分类时应谨慎，因为它是为成年人制定的，在青少年人群中可能非常有限。计划对更大队列进行长期研究。
