Article ID: WMC003775 ISSN 2046-1690 Spectrum of Breast Disorders in A Pediatric Surgery Clinic: Retrospective Study Corresponding Author: Dr. Atilla Senayli, Assistant Prof., Pediatric Surgery, Yildirim Beyazit University - Turkey Submitting Author: Dr. Atilla Senayli, Assistant Prof., Pediatric Surgery, Yildirim Beyazit University - Turkey Article ID: WMC003775 Article Type: Original Articles Submitted on:26-Oct-2012, 05:59:39 AM GMT Published on: 26-Oct-2012, 06:25:34 PM GMT Article URL: http://www.webmedcentral.com/article_view/3775 Subject Categories:PAEDIATRIC SURGERY Keywords:Breast; Disorders; Children How to cite the article:Senayli A, Karaveliolu A , Koseoglu B , Akln M , Ozguner I . Spectrum of Breast Disorders in A Pediatric Surgery Clinic: Retrospective Study . WebmedCentral PAEDIATRIC SURGERY 2012;3(10):WMC003775 Copyright: This is an open-access article distributed under the terms of the Creative Commons Attribution License(CC-BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Source(s) of Funding: None Competing Interests: None WebmedCentral > Original Articles Page 1 of 7 WMC003775 Downloaded from http://www.webmedcentral.com on 26-Oct-2012, 06:25:34 PM Spectrum of Breast Disorders in A Pediatric Surgery Clinic: Retrospective Study Author(s): Senayli A, Karaveliolu A , Koseoglu B , Akln M , Ozguner I Abstract Paediatricians must pay attention to breast disorders that may be seen at any paediatric age group. (1). Objective: There are a limited and inadequate data Although most of the diseases are benign as a fact, for breast diseases in children. This may be because the possibility of malignancy can never be ignored of low importance expectations of practitioners' for (1-3). The major problem to form a confident clinical breast problems in which laboratory tools are treatment protocol is very little published data for rarely used. However, breast issues of children may breast diseases of adolescence (2,3). possibly remain missing as a consequence of Underestimation of the breast disorders often by insufficient data. In this article, we encourage the clinicians may be the reason of publication authors to share their experiences and publish deficiencies (4). On contrary to this, breast disorders procedures. of children and adolescent must be important topics for physicians and gynecologist (4). Parents anxiety Settings and Methods: Pediatric surgery documents and patients’ fear about progressive breast disorders between 2005 and 2011 were evaluated to are the main reason of this suggestion (4). demonstrate breast disorders. Diagnosis, gender, age, More data is needed to make decisions on breast ultrasonography, treatment modalities and follow-up diseases. For data expansion, we aim to add 6-year procedures were studied in this study. Literature data experience for breast diseases to literature. is compared with the study findings. What could be the lack of practice due to lack of data in the literature are Methods presented. Results: Seventy-two patients were diagnosed with In Kecioren Education Hospital, documents of breast diseases among 9958 patients. Twenty-eight pediatric surgery between 2005 and 2011 were patients were male and 44 patients were female. evaluated for breast diseases. Some of the authors Median ages of the male and female patients were contributing to this study previously worked in the 12.5 and 14 respectively. Physical examination was hospital. Some authors are still working. In this study, the only practice used for most patients. spectrum of breast disorders, gender, age, Ultrasonography was used for 27 patients. Laboratory ultrasonography, treatment modalities, and follow-up examinations were not used. Only one patient was periods are presented. Diseases were evaluated with operated. Male and female patients were followed for International Classification of Diseases Code-10 2 and 3 years, respectively. (ICD-10). Authors had agreed on similar codes for diagnosis of unknown lesions like masses. Most of Conclusion: Although literature data is present for undefined masses were diagnosed as “Benign Breast breast disorders, clinical documents published by Dysplasia”. paediatric surgery on this subject is rare. Simple treatment modalities, necessity of long follow-up Results periods and clinically unimportant disorders may be the reason of very little published information. Different managements and experiences for breast diseases Seventy-two patients were diagnosed with breast must be published to add value to a lacking and disease in 9958 cases. Twenty-eight patients were neglected issue. The only mission of this study is to male and 44 patients were female. Median ages of the invite authors all over the world to add their data about male and female patients were 12.5 and 14 breast disorders. respectively. Accessory breast (1 patient, 1.4%), benign breast dysplasia (51 patients, 70.8%), Introduction gynecomastia (6 patients, 8.4%), breast hypertrophy (4 patients, 5.5 %), non-puerperal infective mastitis (4 WebmedCentral > Original Articles Page 2 of 7 WMC003775 Downloaded from http://www.webmedcentral.com on 26-Oct-2012, 06:25:34 PM patients, 5.5 %), non-puerperal breast abscess (3 Therefore, we performed a randomized treatment. We patients, 4.2%), nipple fissure (2 patients, 2.8%), and invite authors to share their experience in this regard. diffuse breast cyst (1 patient, 1.4%) was the result of Otherwise, the disease can’t be formulated for better the study. Breast ultrasonography was used for 27 decision-making. patients. Very few patients had blood samples and other laboratory tests were performed. Therefore, Breast masses have usually been diagnosed as laboratory studies are not included in article. Physical benign physiologic enlargements or developmental examination has been the main assessment and changes (6). Fibroadenoma is the most seen benign management tool. Only one patient was operated. dysplasia of female (1-3). Fibroadenoma could be Male and female patients were followed-up for 3 and 2 72-75% of the breast masses (4). In our series, 70.8% years respectively. Results were demonstrated in patients (n=51/72) were diagnosed with benign breast Table-1. dysplasia. In International coding system for diseases is limited on breast problems. Seeing this, “Benign Discussion Breast Dysplasia” was preferred for the description of breast masses in our practice. Thirty patients (30/72, 41.6%) in this group were female and all female Breast disorders can be diagnosed also in children patients had fibroadenoma. Fibroadenomas are (3,5). Although most breast disorders of this age are estrogen-sensitive tumors. Due to this sensitivity, benign, parents are always fear of malignancy (1). fibroadenomas can be seen in patients premenarchal Parents' concerns are the most effective factor for the and 20 years old (4). Patients, in our study, are found treatment of breast disorders. Sometimes, these to be premenarchal or older, as mentioned in literature. concerns may force physicians for surgical Ultrasound (US) is important for the diagnosis of intervention. Physicians must know the process of breast disorders especially masses (1,2). Only 13 these diseases at adolescence to do the right thing for ultrasonography examinations were performed for the child and to convince parents. In contrast, the female patients in this group and therefore, the literature contains adolescence diseases is limited, number of evaluations for diagnosis may be accepted and physicians have often overlooked the diseases. insufficient. Typical physical examination findings of breast masses may be one of the reasons. Low Breast problems are rarely examined in pediatric expectations for USG findings about the masses of surgery clinics. Therefore, collections of the patients' patients may be another important reason. Also, data at any number will be meaningful. Total number follow-up decisions of the authors may interrupt of our patients is 72. Nevertheless, we share our ultrasonography evaluations. experience for accessory breast, benign breast dysplasia, gynecomastia, breast hypertrophy, Breast masses, particularly fibroadenoma, due to the non-puerperal infective mastitis, non-puerperal breast menstrual cycle can be treated with hormones. For abscess, nipple fissure and diffuse breast cyst. this purpose, to monitor two or three menstrual cycles, may be sufficient to decide (1). However, to our Accessory breast is a true polymastia containing all knowledge, management schedule of these problems components of mammary but the disease forms a is not present, yet. In this section; the breast masses small percentage of the polymastia disorders. (5). variations, ultrasound necessity, sufficiency of Polythelia, the existence of accessory nipple and ultrasound, or predicting factors are still unknown. In areolae, is the most seen anomaly of this issue. (5). In fact, we realize that our data was also defective for all literature, enough data about the demography, these factors. Therefore, practices in our clinic will also characteristics and statistics for accessory breast be revised. disorders has not been collected. In our clinics, only one case was present and the disease was at the On the other hand, twenty-one male patients (21/72, axillary region. Ultrasonography was used for the 29%) were diagnosed with benign breast dysplasia. confirmation of disease. At the same time, she was the Median age of these patients was 12 and only 6 were only