Clinicopathological profile of breast lesions and their management in paediatric patients seen in a tertiary health facility in Southern Nigeria

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Okoro Philemon E*, Obiorah Christopher, “Clinicopathological profile of breast lesions and their management in paediatric patients seen in a tertiary health facility in Southern Nigeria”, ijmhs, vol. 10, no. 03, pp. 839–842, Mar. 2020.
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Abstract

Introduction
Breast diseases are less common in the paediatric age group than in adults. Accordingly,
less attention has been given to this group of diseases. Hence there is not enough
literature on so many aspects including pathology,diagnosis, treatment and outcome.
Commonly, surgeons and researchers apply the same principles deployed for adults.
Aims and Objectives
To evaluate the clinical and pathological pattern of paediatric breast diseases seen in
our centre, and to review their treatment.
Methods
This is a four year retrospective review of cases of breast diseases seen in patients
who are of age 18 years and less in our centre from July 2015 to May 2019. The data
extracted were age, gender, clinical features, clinical diagnosis, laterality of breast
lesion, treatment offered, histological diagnosis. The data were collated and analyzed
using the SPSS 17.0
Results
One hundred and ninety one cases were analyzed. They comprised 29(15%) males and
162(85%) females giving a male female ratio of 1:6. The breast lesions were in the right
breast in 84(44%) cases, in the left breast in 75(39.3%) cases and bilateral in 32(16.7%)
cases. Breast lumps were the commonest clinical presentation, and fibroadenoma and
fibroadenosis constituted 79.2% of cases. There were no malignant lesions.
Conclusion
Breast lesions are not uncommon among our paediatric patients. The majority of the
lesions presented as breast lump in the teenage years. Fibroadenoma and fibroadenosis
are the commonest breast lesions and malignant lesions were not encountered. Less
invasive methods of diagnosis and treatment are recommended.
Key words: Breast–Lesions–Paediatric–Profile–Management

KEYWORDS:

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References

[1] Odle TG. Radiol Technol Breast disease in children and adolescents. 2015;86(3):301–324. [2] Cayci C, Simmons P, Petty P, Lemaine V. Gynecomastia in Adolescent Males. Seminars in Plastic Surgery. 2013;27(01):056–061. Available from: https://dx.doi.org/10.1055/s-0033-1347166. [3] Omar L, Gleason MK, Pfeifer CM, Sharma P, Kwon JK. Management of Palpable Pediatric Breast Masses With Ul-trasound Characteristics of Fibroadenoma: A More Conservative Approach. American Journal of Roentgenology.2019;212(2):450–455. Available from: https://dx.doi.org/10.2214/ajr.17.19482. [4] Schaffar R, Bouchardy C, Chappuis PO, Bodmer A, Benhamou S, Rapiti E. A population-based cohort of young women diagnosed with breast cancer in Geneva, Switzerland. PLOS ONE. 2019;14(9):e0222136–e0222136. Availablefrom: https://dx.doi.org/10.1371/journal.pone.0222136. [5] Keyzer-Dekker CMG, de Vries J, Mertens MC, Roukema JA, van der Steeg AFW. The impact of diagnosis and trait anxiety on psychological distress in women with early stage breast cancer: A prospective study. British Journal of Health Psychology. 2014;19(4):783–794. Available from: https://dx. doi.org/10.1111/bjhp.12076. [6] STAUFFER WM, KAMAT D. Neonatal mastitis. Pediatric Emergency Care. 2003;19(3):165–166. Available from: https://dx.doi.org/10.1097/01.pec.0000081239.98249.09. [7] Durmaz E, Oztek MA, Habibi HA, Kesimal U, Sindel HT. Breast diseases in children: the spectrum of radiologic findings in a cohort study. Diagnostic and Interventional Radiology. 2017;23(6):407–413. Available from: https://dx.doi.org/10.5152/dir.2017.17033. [8] Cohen O, Avinadav E, Sharon E, Pirogovsky A, Freud E. Pediatric and Adolescent Surgical Breast Clinic: Preliminary Experience. Journal of Pediatric and Adolescent Gynecology. 2020;33(1):23–26. Available from: https://dx.doi.org/10.1016/j.jpag.2019.08.010. [9] McLaughlin CM, Gonzalez-Hernandez J, Bennett M, Piper HG. Pediatric breast masses: an argument for observation. Journal of Surgical Research. 2018;228:247–252. Available from: https://dx.doi.org/10.1016/j.jss.2018.03.056. [10] Wang C, Yu N, Zhu L, Zeng A;. [11] Efrat M, Mogilner JG, Iujtman M, Eldemberg D, Kunin J, Eldar S. Neonatal mastitis–diagnosis and treatment. Isr J Med Sci. 1995;31(9):558–60. [12] Mchoney M, Munro F, Mackinlay G;. [13] Hafeez S, Balarezo F, Ricci A;. [14] Richards MK, Goldin AB, Beierle EA, Doski JJ, Goldfarb M, Langer M, et al. Breast Malignancies in Children:Presentation, Management, and Survival. Annals of Surgical Oncology. 2017;24(6):1482–1491. Available from: https://dx.doi.org/10.1245/s10434-016-5747-5. [15] Gunden JR, Bendahhou K, Benider A, Khalil AI, Khalis M, Wilson ML, et al. Evaluating the incidence of inflammatory breast cancer using population- and hospital-based cancer registries in Casablanca, Morocco. Breast Disease. 2019;38(2):39–45. Available from: https://dx.doi.org/10.3233/bd-180357. [16] Westfal ML, Perez NP, Hung YC, Chang DC, Kelleher CM. Pathologic discordance to clinical management decisions suggests overtreatment in pediatric benign breast disease. Breast Cancer Research and Treatment. 2019;176(1):101– 108. Available from: https://dx.doi.org/10.1007/s10549-019-05224-w. [17] Scolnik D, Ruwaili NA. Neonatal mastitis: Controversies in management. Journal of Clinical Neonatology. 2012;1(4):207–207. Available from: https://dx.doi.org/10.4103/2249-4847.105997. [18] and SK. Clinical Evaluation of Breast in Childhood. European Journal of Breast Healt. 2019;15(3):137–140. Available from: https://dx.doi.org/10.5152/ejbh.2019.4745. [19] Ismail S, Alaidi S, Jouni S, Kassab Y, Al-Shehabi Z. Recurrent giant fibroadenomas with transformation to cystosarcoma phyllodes in a 17-year-old girl: a rare case report from Syria. Journal of Medical Case Reports. 2019;13(1):378– 378. Available from: https://dx.doi.org/10.1186/s13256- 019-2313-3. [20] Shahriari M, Ghasemi K, Bordbar M, Shakibazad N. Gynecomastia as a late complication of childhood cancer and its treatment that can affect the quality of life of male survivors. Seminars in Oncology. 2019;46(2):155–159. Available from: https://dx.doi.org/10.1053/j.seminoncol.2019.04.003. [21] Manjiri S, Padmalatha SK, Jeevak S. A Prospective Observational Study of Breast Lumps in Adolescent Girls: Tertiary Care South Indian Teaching Hospital Experience. Indian Journal of Surgical Oncology. 2018;9(3):402–406. Available from: https://dx.doi.org/10.1007/s13193-018-0773-3. [22] Lee EJ, Chang YW, Oh JH, Hwang J, Hong SS, Kim HJ. Breast Lesions in Children and Adolescents: Diagnosis and Management. Korean J Radiol. 2018;(5):978–991. [23] Englert EG, Ares G, Henricks A, Rychlik K, Hunter CJ. Analysis of factors predicting surgical intervention and associated costs in pediatric breast masses: a single center study. Pediatric Surgery International. 2018;34(6):679–685. Available from: https://dx.doi.org/10.1007/s00383-018-4268-7. [24] Valeur NS, Rahbar H, Chapman T;. [25] Sancho-Garnier H, Colonna M. Breast cancer epidemiology. Presse Med. 2019;48(10):1076–1084

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References

[1] Odle TG. Radiol Technol Breast disease in children and adolescents. 2015;86(3):301–324.
[2] Cayci C, Simmons P, Petty P, Lemaine V. Gynecomastia in Adolescent Males. Seminars in Plastic Surgery. 2013;27(01):056–061. Available from: https://dx.doi.org/10.1055/s-0033-1347166.
[3] Omar L, Gleason MK, Pfeifer CM, Sharma P, Kwon JK. Management of Palpable Pediatric Breast Masses With Ul-trasound Characteristics of Fibroadenoma: A More Conservative Approach. American Journal of Roentgenology.2019;212(2):450–455. Available from: https://dx.doi.org/10.2214/ajr.17.19482.
[4] Schaffar R, Bouchardy C, Chappuis PO, Bodmer A, Benhamou S, Rapiti E. A population-based cohort of young women diagnosed with breast cancer in Geneva, Switzerland. PLOS ONE. 2019;14(9):e0222136–e0222136. Availablefrom: https://dx.doi.org/10.1371/journal.pone.0222136.
[5] Keyzer-Dekker CMG, de Vries J, Mertens MC, Roukema JA, van der Steeg AFW. The impact of diagnosis and trait anxiety on psychological distress in women with early stage breast cancer: A prospective study. British Journal of Health Psychology. 2014;19(4):783–794. Available from: https://dx. doi.org/10.1111/bjhp.12076.
[6] STAUFFER WM, KAMAT D. Neonatal mastitis. Pediatric Emergency Care. 2003;19(3):165–166. Available from: https://dx.doi.org/10.1097/01.pec.0000081239.98249.09.
[7] Durmaz E, Oztek MA, Habibi HA, Kesimal U, Sindel HT. Breast diseases in children: the spectrum of radiologic findings in a cohort study. Diagnostic and Interventional Radiology. 2017;23(6):407–413. Available from: https://dx.doi.org/10.5152/dir.2017.17033.
[8] Cohen O, Avinadav E, Sharon E, Pirogovsky A, Freud E. Pediatric and Adolescent Surgical Breast Clinic: Preliminary Experience. Journal of Pediatric and Adolescent Gynecology. 2020;33(1):23–26. Available from: https://dx.doi.org/10.1016/j.jpag.2019.08.010.
[9] McLaughlin CM, Gonzalez-Hernandez J, Bennett M, Piper HG. Pediatric breast masses: an argument for observation.
Journal of Surgical Research. 2018;228:247–252. Available from: https://dx.doi.org/10.1016/j.jss.2018.03.056.
[10] Wang C, Yu N, Zhu L, Zeng A;.
[11] Efrat M, Mogilner JG, Iujtman M, Eldemberg D, Kunin J, Eldar S. Neonatal mastitis–diagnosis and treatment. Isr J Med Sci. 1995;31(9):558–60.
[12] Mchoney M, Munro F, Mackinlay G;.
[13] Hafeez S, Balarezo F, Ricci A;.
[14] Richards MK, Goldin AB, Beierle EA, Doski JJ, Goldfarb M, Langer M, et al. Breast Malignancies in Children:Presentation, Management, and Survival. Annals of
Surgical Oncology. 2017;24(6):1482–1491. Available from: https://dx.doi.org/10.1245/s10434-016-5747-5.
[15] Gunden JR, Bendahhou K, Benider A, Khalil AI, Khalis M, Wilson ML, et al. Evaluating the incidence of inflammatory breast cancer using population- and hospital-based cancer registries in Casablanca, Morocco. Breast Disease. 2019;38(2):39–45. Available from: https://dx.doi.org/10.3233/bd-180357.
[16] Westfal ML, Perez NP, Hung YC, Chang DC, Kelleher CM. Pathologic discordance to clinical management decisions suggests overtreatment in pediatric benign breast disease. Breast Cancer Research and Treatment. 2019;176(1):101– 108. Available from: https://dx.doi.org/10.1007/s10549-019-05224-w.
[17] Scolnik D, Ruwaili NA. Neonatal mastitis: Controversies in management. Journal of Clinical Neonatology. 2012;1(4):207–207. Available from: https://dx.doi.org/10.4103/2249-4847.105997.
[18] and SK. Clinical Evaluation of Breast in Childhood. European Journal of Breast Healt. 2019;15(3):137–140. Available
from: https://dx.doi.org/10.5152/ejbh.2019.4745.
[19] Ismail S, Alaidi S, Jouni S, Kassab Y, Al-Shehabi Z. Recurrent giant fibroadenomas with transformation to cystosarcoma phyllodes in a 17-year-old girl: a rare case report from Syria. Journal of Medical Case Reports. 2019;13(1):378– 378. Available from: https://dx.doi.org/10.1186/s13256-
019-2313-3.
[20] Shahriari M, Ghasemi K, Bordbar M, Shakibazad N. Gynecomastia as a late complication of childhood cancer and its treatment that can affect the quality of life of male survivors. Seminars in Oncology. 2019;46(2):155–159. Available from: https://dx.doi.org/10.1053/j.seminoncol.2019.04.003.
[21] Manjiri S, Padmalatha SK, Jeevak S. A Prospective Observational Study of Breast Lumps in Adolescent Girls: Tertiary Care South Indian Teaching Hospital Experience. Indian Journal of Surgical Oncology. 2018;9(3):402–406. Available from: https://dx.doi.org/10.1007/s13193-018-0773-3.
[22] Lee EJ, Chang YW, Oh JH, Hwang J, Hong SS, Kim HJ. Breast Lesions in Children and Adolescents: Diagnosis and Management. Korean J Radiol. 2018;(5):978–991.
[23] Englert EG, Ares G, Henricks A, Rychlik K, Hunter CJ. Analysis of factors predicting surgical intervention and associated costs in pediatric breast masses: a single center study. Pediatric Surgery International. 2018;34(6):679–685. Available from: https://dx.doi.org/10.1007/s00383-018-4268-7.
[24] Valeur NS, Rahbar H, Chapman T;.
[25] Sancho-Garnier H, Colonna M. Breast cancer epidemiology. Presse Med. 2019;48(10):1076–1084

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