Breast masses in adolescent females

Abstract

In a retrospective study of 38 adolescent females operated on for mammary masses, 42 fibroadenomata (FA), 2 fibrous scars around abscesses, and one papilloma were found. All were postmenarchal. Clinical and pathological features were reviewed and the patients reexamined or interviewed. FA were mostly asymptomatic and removed a few weeks after incidental discovery. They were often seen in Jewish girls of parents born in North Africa and the Middle East, and were more frequently located in the outer superior quadrant of the left breast. New FA appeared in almost half of the cases later on in the same breast, as well as in the other breast, or bilaterally. Necrosis occurred in three FA and was unrelated to the size of the tumor. There was no correlation between the size of FA, multiplicity, or necrosis, nor between increased stromal or epithelial atypia, cellularity, or mitotic activity. One explanation for the high rate of multiplicity might be related to this neoplasm occurring in an actively developing organ under hormonal control. There was no increased breast carcinoma apparent in the family history. Therefore, except in cases of fast-growing tumors, a conservative approach is recommended because of the frequency of multiple FA as well as aesthetical postoperative complications.

Female Breast Masses During Childhood: A 25-Year Review

“…The diagnosis was usually made from physical examination findings due to the particular characteristics of the tumor and confiTIned by ultrasound scan. As in other series, fibroadenoma was more common in the left breast and outer-upper quadrant (7,8,15). Histopathological classification of fibroadenoma such as juvenile, adult, pericanalicular or intracanalicular are dependent primarilyon size and the amount and cellularity of the stroma.…”

“…There are reports in favor of conservative approach for fibroadenomas because of the long-term aesthetical problems such as scar formation, keloids and persistent local pain (5,15). However, apart from operative complications (nipple slough, hematoma) , we did not encounter such problems in the long-term follow-up.…”

“…There are no prognostic implications in these terms. There is no correlation between the size of fibroadenoma, multiplicity, or necrosis, nor between increased stromal or epithelial atypia, cellularity, or mitotic activity (15). Apart from one report (3), there is general agreement that fibroadenoma is not a risk factor for breast cancer and no proven link has been shown between any type of fibroadenoma and carcinoma.…”

Diagnostic and therapeutic procedures in adolescents and young adults with changes of the breast

“…[34] wskazują, że postępowanie zachowawcze wraz z systematyczną kontrolą specjalistyczną jest najbardziej właściwe u młodych pacjentów, ponieważ pozwala uniknąć powikłań leczenia operacyjnego w postaci rozległych blizn, bliznowców oraz długotrwałego bólu operowanej piersi, a jedyny wyjątek od tej zasady stanowią zmiany łagodne wykazujące tendencję do szybkiej progresji.…”

Breast Disorders

“…Fibroadenomas are the most common solid breast mass excised in paediatric and adolescent surgical series (West et al 1995;Pacinda and Ramzy 1998;Siegal et al 1992). These benign fibroepithelial tumours develop from a single duct and show a hormonal response similar to that of normal breast tissue.…”