EVALUATION OF PREOPERATIVE SURGICAL DECISIONS AND SURGICAL OUTCOMES IN PEDIATRIC BREAST MASSES

43. Ulusal Çocuk Cerrahisi kongresi ve Mısır Çocuk Cerrahisi ortak kongresi, İstanbul, Türkiye, 21 - 24 Ekim 2026, ss.194-195, (Özet Bildiri)

Objective: Breast masses are rare in childhood; surgical decision-making relies primarily on clinical presentation and

radiological imaging. In cases with suspected malignancy, biopsy provides essential histopathological and follow-up

data. This study aimed to evaluate the factors influencing preoperative surgical decisions and clinical outcomes in

pediatric patients undergoing breast mass excision.

Methods: Demographic features, symptoms, physical examination findings, imaging results, surgical interventions, and

histopathological outcomes of 39 pediatric patients who underwent surgery for breast masses between 2016 and 2026

were retrospectively reviewed.

Results: The mean patient age was 15.0 ± 3.2 years, and 37 patients (94.8%) were female. A palpable mass was present

in all cases. Concomitant symptoms included mastalgia (41%), nipple discharge (20.5%; 5.1% bloody), and a positive

family history (20.5%). Preoperative ultrasonography revealed BI-RADS 4A lesions in 32 patients (82.0%), with a median

lesion size of 42 mm (2–95 mm). Preoperative Magnetic resonance imaging was performed in six cases, and tru-cut

biopsy was utilized in 20 cases (51.2%). All patients underwent surgical excision via a periareolar incision; hemovac

drains were placed in two patients (5.1%).

Histopathological evaluation demonstrated juvenile fibroadenoma in 28 cases (71.7%) and benign phyllodes

tumor in eight cases (20.5%). One patient initially diagnosed with juvenile fibroadenoma required re-operation for

a metachronous contralateral mass, which was identified as a phyllodes tumor. Ten patients (25.6%) are currently

monitored for new contralateral BI-RADS 2 and 3 lesions. Long-term follow-up showed no breast asymmetry, mortality,

or requirement for postoperative adjuvant chemotherapy or radiotherapy.

Conclusion: Although the vast majority of pediatric breast lesions are benign fibroepithelial tumors, neoplasms with

malignant potential must be considered in the differential diagnosis. Current preoperative imaging modalities are

insufficient to completely exclude borderline or malignant lesions. Given the developing breast tissue in pediatric

patients, establishing novel diagnostic parameters is crucial to prevent unnecessary surgical interventions.