Breast Masses in Children and Adolescents: What is the Burden of Breast Cancer?

Abstract

Breast masses in children and adolescence are uncommon and are mostly benign. Nevertheless, the increasing awareness of breast cancer in the population has increased the anxiety over breast masses in these patients. Breast lesions in these patients are discussed in this article with a review of world literature
Aim: To review the age incidence and histopathologic types of breast lesions in children and adolescents.
Method: A 25 year (January 1985- December 2009) retrospective study of all patients who had breast biopsies.
Setting: Departments of Pathology and Surgery, University of Benin Teaching Hospital, Benin City, Nigeria.
Results: Of 2967 cases of breast lesions encountered within the 25 year period of study, 330 (11.1%) cases occurred in children and adolescents. Most cases were in females [321 cases (97.3%)] with only 9(0.7%) cases in males giving a female to male ratio of 35.6:1. Age range was 9-19 years. Mean age was 16.99 years±Std 2.0 years, with median and modal ages of 18 and 19 years respectively. Breast lesions were rare in the 1^st decade of life with only one case [ a case of fibroadenoma in a 9 year old female]. Histologically, majority of cases were benign 326(98.8%). Only 4(1.2%) cases were malignant. Fibroadenoma was the most common lesion constituting 194(58.8%) cases, followed by fibrocystic change accounting for 54 cases (16.4%)].
Conclusion: Lesions were mostly benign and predominantly fibro-adenomas. Though malignant lesions were very rare, the possibility of malignant disease must be considered in the differential diagnosis of breast masses in this age group.

Keywords. Breast mass; childhood; adolescent