tiny tatas 🍼
budding buds 🌱
puberty party 🎊
scan it like you mean it !!
to poke or not to poke.. 🗡️
100
Most common cause of bilateral breast enlargement in a newborn?
- Neonatal breast hypertrophy
100
Most common benign cause of breast enlargement before age 8?
Premature thelarche
100
Most common breast mass in adolescents?
Fibroadenoma
100
First-line imaging for pediatric breast masses?
ultrasound !
100
What is the preferred biopsy technique in general for the breast?
core needle biopsy
200
Most common organism causing neonatal mastitis?
Staphylococcus aureus
200
Breast development plus pubic hair should make you think of...?
Precocious puberty: consult endo!
200
What benign male breast condition peaks around ages 13-14?
physiologic gynecomastia
200
Why isn't mammography routinely used?
dense breast tissue will decrease the sensitivity of the mammography
200
Two indications for biopsy
- rapid growth
- suspicious ultrasound
- persistent enlagement
- risk factors (prior malignancy, cancer predisposition syndromes Li fraumeni, cowden etc..)
300
Why should incision & drainage through the breast bud generally be avoided?
- It can destroy the breast anlage causing permanent asymmetry/amastia and impair future breast development
300
What imaging is first-line if diagnosis is uncertain?
US !
300
Name two ultrasound features of a fibroadenoma.
- Oval
- Well circumscribed
- hypoechoic
- mobile
300
When should MRI be considered?
Suspected malignancy or surgical planning
300
A 13-year-old girl has a 2.5 cm, well-circumscribed, mobile breast mass with classic fibroadenoma features on ultrasound. She has no risk factors and the lesion has been present for one month.
Observation and ultrasound follow-up in 6 months.
Pearl: Most pediatric fibroadenomas remain stable or regress, and unnecessary intervention risks cosmetic deformity and injury to the developing breast.
400
What ultrasound finding suggests a neonatal breast abscess?
- Complex fluid collection with peripheral Doppler vascularity
400
A breast abscess requires drainage. What technique is preferred to minimize future cosmetic deformity: I&D or US guided aspiration?
ultrasound-guided aspiration is preferred rather than incision through the breast bud
400
What tumor can closely mimic a juvenile fibroadenoma?
Phyllodes tumor
400
About what percentage of pediatric breast ultrasounds are completely normal?
~52%
400
A 15-year-old undergoes core needle biopsy for a rapidly enlarging breast mass. Pathology returns fibroepithelial lesion
Surgical excision, because 25-35% of FELs are upgraded to phyllodes tumors after excision.
500
A newborn has bilateral breast enlargement without erythema or fever. Management?
Observation, likely neonatal breast hypertrophy!
500
Name one chest wall malignancy that can mimic a breast mass.
- Ewing sarcoma
- Rhabdomyosarcoma
- Lymphoma
500
What three findings should make you suspicious for phyllodes?
- rapid growth
- > 3 cm
- painless
- hard
- cleft-like cystic spaces on US
500
What imaging finding is most concerning for malignancy?
- irregular margins
- posterior shadowing
- non-parallel orientation
- complex solid/cystic lesion
500
A 14-year-old has a 5-cm rapidly enlarging breast mass. Ultrasound is suspicious for a phyllodes tumor. Core biopsy is inconclusive.
Excisional biopsy (wide local excision)