Imaging Evaluation and Management of Breast Symptoms in the Pediatric Population.

The clinical approach, differential diagnosis, diagnostic imaging, and management of breast masses differs between adult and pediatric patients. Breast symptoms in pediatric populations are likely to be normal, variants of normal development, or classically benign. When evaluating pediatric patients, a thorough history and physical examination is key and may include US imaging if clinically indicated. Currently, there are no consensus guidelines from professional societies specific to the imaging evaluation, reporting, or management of the pediatric breast. Inappropriate utilization of additional imaging or biopsy recommendations can cause stress to patients and caregivers, added financial costs, and potential damage to the developing breast. As such, it is increasingly important for radiologists to have a clear understanding of the expected physical and imaging findings for developing breast tissue, developmental abnormalities, benign conditions, and rare malignancies. This review summarizes the expected normal developmental breast changes in the pediatric population as well as common anatomic variants. Both benign and rare malignant breast pathologies are reviewed with a discussion about clinical presentation and management to guide breast imaging trainees and practicing radiologists.