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Pathologic Breast Conditions in Childhood and Adolescence

Evaluation by Sonographic Diagnosis

Klinik für Gynäkologie, Gynäkologische Endokrinologie, und Onkologie (K.B., V.F.D., P.H., U.W.), Institut für Pathologie (A.R.), and Senologische Diagnostik (K.B., V.F.D., K.-J.K., U.W.), Philipps-Universität Marburg, Marburg, Germany; and Diagnostische Radiologie, Friedrich-Alexander-Universität Erlangen/Nürnberg, Erlangen, Germany (R.S.-W.).

Address correspondence to Karin Bock, MD, Medizinisches Zentrum für Frauenheilkunde und Geburtshilfe, Philipps-Universität Marburg, Pilgrimstein 3, 35033 Marburg, Germany. E-mail: bock{at}med.uni-marburg.de

Objective. The growing awareness of female breast cancer has led to increased sensitivity toward pathologic breast conditions in children and adolescents. Thus, approximately 15% of patients in child and adolescent gynecology are referred for the first time because of conspicuous features of the breast such as pain, palpable masses, and other findings on visual inspection. The aim of this study was to analyze the underlying diagnoses and diseases and determine the status of breast sonography in the diagnostic process. Methods. The study population consisted of 62 female patients between 8 weeks and 20 years of age (1997–2002) who were examined clinically, followed by standardized sonography (7.5–13 MHz, conventional B-mode panoramic sonography). Presumed diagnoses were confirmed by biopsy in some patients (n = 16) and by follow-up with clinical examination and sonography in most cases (n = 46). Results. The clinical and sonographic evaluation confirmed 4 main groups of diagnoses: benign tumors (15), developmental disturbances (14), cystic changes (11), and inherent defects (7). In the remaining cases, the findings were no abnormality (9), nipple discharge without evidence of pathologic or morphologic correlates (3), abscesses (2), and epidermoid cyst (1). Conclusions. Knowledge of regular breast development and its variants is essential for the physician. Given knowledge of the sonographic appearance of physiologic breast development and specific lesions, breast sonography is most helpful in identifying and characterizing abnormalities and guiding further investigation.

Key Words: adolescence • breast disease • breast sonography • childhood • panoramic sonography

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