WOFAPS 2025 8th World Congress of Pediatric Surgery

Armanç Güneş, Hakan Özcan, Sefer Tolga Okay, Esra Özçakır, Mete Kaya

Department of Pediatric Surgery, Health Sciences University, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Türkiye

---

Purpose:

To evaluate the clinical features, imaging findings, surgical indications, histopathological diagnoses, and treatment outcomes of adolescent breast lesions managed at a pediatric surgical center.

Method:

This retrospective study included 40 adolescent girls aged 13–17 years who presented with palpable breast masses between 2016 and 2025. Data regarding clinical presentation, lesion size, ultrasonographic findings, BIRADS classification, tru-cut biopsy results, surgical technique, pathology, and follow-up were reviewed.

Lesions smaller than 5 cm, in the absence of symptoms or cosmetic concerns, were monitored through ultrasonography and physical examination at six-month intervals, then annually. Patients were educated on breast self-examination. Lesions 5 cm or larger were considered for surgical excision.

Results:

The mean age was 15.7 years. All patients presented with a palpable mass; 15 had mastalgia, and 2 had nipple discharge (1 serous, 1 galactorrhea). The average lesion size was 40×30 mm. Small contralateral lesions (~10 mm) were observed in 11 patients; 2 patients had dual ipsilateral lesions.

Sixteen patients met criteria for conservative follow-up. During surveillance, 8 lesions grew by approximately 50%, while 8 doubled in size. Imaging showed BIRADS 4A in 8 cases, 4B in 1, 4C in 2, and BIRADS 3 in the remainder. Tru-cut biopsy was performed in 6 patients due to clinical and sonographic suspicion of malignancy, revealing 1 tubular adenoma and 5 fibroadenomas.

All 40 patients underwent complete excision via areolar incision. The mean hospital stay was 2.2 days. Final pathology showed 2 tubular adenomas, 1 intraductal papilloma, and 37 fibroadenomas. No malignancies were detected. No recurrences or secondary surgeries occurred. Associated lesions regressed spontaneously. Mean follow-up duration was 2 years.

Conclusions:

Although generally and highly likely to be histologically benign, adolescent breast lesions require individualized evaluation. Surgery is appropriate for enlarging or symptomatic lesions. Areolar incision-based excision is safe and ensures excellent long-term outcomes.