Category Archives: Benign Breast Disease

Breast Masses in Children

Breast Masses in Children and Adolescence

Classification of the breast masses in children/adolescence

The process in parethesis below represents an example.

  • Physiological (Gynecomastia)
  • Inflammatory (Abscess)
  • Benign neoplastic (Fibroadenoma, Cystosarcoma phyllodes)
  • Primary malignant (Cystosarcoma phyllodes)
  • Secondary malignant (Lymphoma)

Neonatal breast nodules

Usually due to stimulation by maternal hormones

Cystosarcoma Phyllodes

  • Fibroadenomas and cystosarcoma phyllodes are the most common lesions of the breast in childhood.
  • Cystosarcoma phyllodes present as either benign or malignant but 95% in children are benign.

Best test for initial assessment in pediatric patients with breast mass?


Then what modality for diagnosis of the breast mass?

Fine needle aspiration.  FNA is preferred over core needle biopsy because of the possibility of deformity of the breast in the future with core needle biopsy.

What about excision biopsy in the pediatric breast?

Excisional biopsy should be avoided as an initial diagnostic procedure because the developing breast bud can be mistakenly removed, leading to deformity.

Pseudoangiomatous stromal hyperplasia

PASH = PseudoAngiomatous Stromal Hyperplasia

  • Presents as a distinct mass, area of thickening of breast tissue, or as an incidental finding
  • Biopsy is necessary to confirm diagnosis
  • Excision with negative margin (ie. 1 mm) is treatment – recurrence rate is low (7%) and no further treatment necessary
  • There are findings on mammogram and ultrasound by biopsy is needed for diagnosis.