Fine-needle aspiration of breast masses. A review of its role in diagnosis and management in adolescent patients.

PURPOSE

To assess the role of fine-needle aspiration biopsy (FNA) in the evaluation and management of breast masses in adolescents.

METHODS

All FNAs performed on organ masses over a 15-year period on patients age 21 years and younger were evaluated. Cases were collected from four large university-affiliated teaching hospitals and clinics. Pathology records from the laboratory information systems were reviewed. Data included clinical information, anatomic site, and cytologic diagnoses. Surgical follow-up was included when available.

RESULTS

Three hundred and twenty-five FNAs from 302 patients were reviewed. Of 325 aspirates, 59 were breast FNAs (in 51 patients: 4 males and 47 females). Among all organs, the breast was the most common one aspirated in females. Of the breast aspirates in females, 49% were diagnosed as fibroadenomas. No cases of malignant breast disease or phyllodes tumors were encountered. Surgical biopsy follow-up was available in 23.7% of the patients. Of those masses which were subsequently surgically biopsied, most were diagnosed as either fibroadenoma (11) or juvenile fibroadenoma (two). One other case biopsied showed ductal hyperplasia and adenosis. The majority of the remaining cases were followed up clinically, since the clinical nature and cytologic features of the lesions were those of fibrocystic changes or benign cysts.

CONCLUSIONS

In the series of FNAs we examined, breast masses were the most frequent lesions aspirated in adolescent females, with fibroadenomas being the most common lesion encountered. FNA proved to be a useful and reliable tool in the evaluation and management of masses involving the adolescent breast. The majority of breast masses in adolescents are benign, and lesions can be managed conservatively in this age group. The use of noninvasive diagnostic procedures such as FNA and ultrasound can reduce the need for open surgery during breast development.