Breast Disorders in Children and Adolescents

Abstract

Concerns about problems of the breast are often noted in adolescents and their parents. This review discusses issues and disorders of the breast in children and adolescents, starting with basic principles of embryology and adolescent breast development. Concepts that are covered include congenital breast disorders, abnormal timing of breast development, breast asymmetry, underdeveloped breasts, breast atrophy, tuberous breasts, mammary hyperplasia, fibroadenoma, giant fibroadenoma, cystosarcoma phyllodes, intraductal breast papilloma, adenocarcinoma, mastitis, traumatic breast disorders, benign breast disease, fibrocystic change, mastalgia, gynocomastia, and galactorrhea. A number of figures are provided illustrating breast pathology. Clinicians caring for children and adolescents are encouraged to provide careful assessments of this important organ system.

Breast Cancer Arising from a Suspected Fibroadenoma during Pregnancy: A Case Report and Review of Literature

“…Although extremely rare, sarcomas such as angiosarcoma, osteosarcoma have also been reported to arise within fibroadenomas [18,19]. There is not much data about the malignant transformation of fibroadenoma during pregnancy, researchers have not been able to propose the exact molecular mechanism which initiates and propagates the progression of malignancy within fibroadenoma, but the rapid growth of fibroadenoma under the effect of pregnancy hormones may play an important role [20,21]. Although comparative studies in determining the natural history of fibroadenomas seem to be equivocal, Kuijper et al in a clonality study showed that given the right condition fibroadenomas could progress in both epithelial (carcinoma) and stromal direction (phyllodes tumor) [22].…”

Bloody nipple discharge in children: possible etiologies and selection of appropriate therapy

“…Sometimes a mass is not felt, but palpation can compress a tumor or distended ducts that will then secrete the characteristic discharge [15,16]. Lately, benign phyllodes tumor generally presents as a slow-growing, painless cystic breast tumor, but there may be explosive growth with overlying n breast number skin findings and protrusion from the nipple [17,20]. BND may occur when the tumor involves the areolar area in the last two pathologies.…”

“…Although mostly idiopathic in this age group, a complete hormonal evaluation is indicated because of the possibility of tumors or endocrine disorders [14,20]. Surgical excision should be discussed only if the enlargement fails to regress within a follow-up period ranging from 4 to 6 months, and the breast is cosmetically unacceptable.…”

Rapid, massive and unphysiological breast enlargement

“…However, hormone levels are found to be normal [18,19,34,39,43,48,79,80,91,109], as are skull x-rays [80,107], but there has been one case with an increased level of prolactin [66] and one with mild hypothyroidism [67]. The condition is probably caused by abnorhaal end organ reaction of the breast to hormonal factors [5,18,34,43,48,50,53,54,61,63,67,76,80,87,91,109,112,114]. Because of this, endocrine therapy is by and large unsuccessful [5,6,13,41,42,45,50,56,61,86] or even contraindicated [5,52,76], although there have been reports of success using various drug regimens [13,80,87,…”

“…The condition is probably caused by abnorhaal end organ reaction of the breast to hormonal factors [5,18,34,43,48,50,53,54,61,63,67,76,80,87,91,109,112,114]. Because of this, endocrine therapy is by and large unsuccessful [5,6,13,41,42,45,50,56,61,86] or even contraindicated [5,52,76], although there have been reports of success using various drug regimens [13,80,87,109,1121.…”