Semin Plast Surg 2013; 27(01): 029-035
DOI: 10.1055/s-0033-1343994
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Imaging of the Adolescent Breast

Katie N. Jones
1   Department of Radiology, Mayo Clinic, Rochester, Minnesota
› Author Affiliations
Further Information

Publication History

Publication Date:
23 May 2013 (online)

Abstract

The mainstay of breast imaging in the adolescent is ultrasonography. There is occasionally a need for additional imaging, particularly with magnetic resonance imaging (MRI). Imaging of the adolescent breast differs substantially from the adult in both the imaging modalities utilized and the relative likelihood of pathologies encountered. The majority of lesions in the adolescent are benign, but the presence of a breast lesion may cause anxiety to patients and their families due to the wide awareness of breast malignancy in the adult population. It is important to be aware of the imaging modalities available to image the adolescent breast to prevent unnecessary radiation exposure while answering the clinical question. The current recommendations for adolescent diagnostic and screening breast imaging will be reviewed. Benign breast lesions such as fibroadenomas, fibrocystic change, pseudoangiomatous stromal hyperplasia, gynecomastia, and posttraumatic or infectious lesions with their associated imaging findings and management will be outlined. Additionally, review of breast malignancies that can affect adolescents will provide the reader with features to distinguish benign from malignant processes in the adolescent based on imaging findings and clinical presentation.

 
  • References

  • 1 Parikh J, Bassett LW, Mahoney MC , et al. ACR Appropriateness Criteria Palpable Breast Masses. Reston, VA: American College of Radiology; 2009
  • 2 Mahoney MCBL, Burnside ES , et al. ACR Practice Guideline for the Performance of a Breast Ultrasound Examination. Reston, VA: American College of Radiology; 2011
  • 3 Ciftci AO, Tanyel FC, Büyükpamukçu N, Hiçsönmez A. Female breast masses during childhood: a 25-year review. Eur J Pediatr Surg 1998; 8 (2) 67-70
  • 4 Stavros AT, Thickman D, Rapp CL, Dennis MA, Parker SH, Sisney GA. Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology 1995; 196 (1) 123-134
  • 5 Taylor AJ, Taylor RE. Surveillance for breast cancer after childhood cancer. JAMA 2009; 301 (4) 435-436
  • 6 Bobo JK, Lee NC, Thames SF. Findings from 752,081 clinical breast examinations reported to a national screening program from 1995 through 1998. J Natl Cancer Inst 2000; 92 (12) 971-976
  • 7 Simmons PS, Jayasinghe YL, Wold LE, Melton III LJ. Breast carcinoma in young women. Obstet Gynecol 2011; 118 (3) 529-536
  • 8 Kuhl CK, Kuhn W, Schild H. Management of women at high risk for breast cancer: new imaging beyond mammography. Breast 2005; 14 (6) 480-486
  • 9 Greydanus DE, Matytsina L, Gains M. Breast disorders in children and adolescents. Prim Care 2006; 33 (2) 455-502
  • 10 Chung EM, Cube R, Hall GJ, González C, Stocker JT, Glassman LM. From the archives of the AFIP: breast masses in children and adolescents: radiologic-pathologic correlation. Radiographics 2009; 29 (3) 907-931
  • 11 García CJ, Espinoza A, Dinamarca V , et al. Breast US in children and adolescents. Radiographics 2000; 20 (6) 1605-1612
  • 12 de Vries L, Guz-Mark A, Lazar L, Reches A, Phillip M. Premature thelarche: age at presentation affects clinical course but not clinical characteristics or risk to progress to precocious puberty. J Pediatr 2010; 156 (3) 466-471
  • 13 Coffin CM. The breast. In: Stocker JT, Dehnner LP, , eds. Pediatric Pathology, 2nd ed. Lippincott Williams & Wilkins; 2002: 993-1015
  • 14 Dialani V, Baum J, Mehta TS. Sonographic features of gynecomastia. J Ultrasound Med 2010; 29 (4) 539-547
  • 15 Appelbaum AH, Evans GF, Levy KR, Amirkhan RH, Schumpert TD. Mammographic appearances of male breast disease. Radiographics 1999; 19 (3) 559-568
  • 16 Sklair-Levy M, Sella T, Alweiss T, Craciun I, Libson E, Mally B. Incidence and management of complex fibroadenomas. AJR Am J Roentgenol 2008; 190 (1) 214-218
  • 17 Simmons PS, Wold LE. Surgically treated breast disease in adolescent females - a retrospective review of 185 cases. Adolesc Pediatr Gynecol 1989; 2 (2) 95-98
  • 18 Amshel CE, Sibley E. Multiple unilateral fibroadenomas. Breast J 2001; 7 (3) 189-191
  • 19 Coffin CM. The breast. In: Stocker JT, Dehnner LP, , eds. Pediatric Pathology, 2nd ed. Lippincott Williams & Wilkins; 2002: 993-1015
  • 20 Carty NJ, Carter C, Rubin C, Ravichandran D, Royle GT, Taylor I. Management of fibroadenoma of the breast. Ann R Coll Surg Engl 1995; 77 (2) 127-130
  • 21 Kronemer KA, Rhee K, Siegel MJ, Sievert L, Hildebolt CF. Gray scale sonography of breast masses in adolescent girls. J Ultrasound Med 2001; 20 (5) 491-496 , quiz 498
  • 22 Alle KM, Moss J, Venegas RJ, Khalkhali I, Klein SR. Conservative management of fibroadenoma of the breast. Br J Surg 1996; 83 (7) 992-993
  • 23 Simmons PS. Breast disorders in adolescent females. Curr Opin Obstet Gynecol 2001; 13 (5) 459-461
  • 24 Ibrahim RE, Sciotto CG, Weidner N. Pseudoangiomatous hyperplasia of mammary stroma. Some observations regarding its clinicopathologic spectrum. Cancer 1989; 63 (6) 1154-1160
  • 25 Shehata BM, Fishman I, Collings MH , et al. Pseudoangiomatous stromal hyperplasia of the breast in pediatric patients: an underrecognized entity. Pediatr Dev Pathol 2009; 12 (6) 450-454
  • 26 Baker M, Chen H, Latchaw L, Memoli V, Ornvold K. Pseudoangiomatous stromal hyperplasia of the breast in a 10-year-old girl. J Pediatr Surg 2011; 46 (8) e27-e31
  • 27 Jones KN, Glazebrook KN, Reynolds C. Pseudoangiomatous stromal hyperplasia: imaging findings with pathologic and clinical correlation. AJR Am J Roentgenol 2010; 195 (4) 1036-1042
  • 28 Gow KW, Mayfield JK, Lloyd D, Shehata BM. Pseudoangiomatous stromal hyperplasia of the breast in two adolescent females. Am Surg 2004; 70 (7) 605-608
  • 29 Gresik CM, Godellas C, Aranha GV, Rajan P, Shoup M. Pseudoangiomatous stromal hyperplasia of the breast: a contemporary approach to its clinical and radiologic features and ideal management. Surgery 2010; 148 (4) 752-757 , discussion 757–758
  • 30 Powell CM, Cranor ML, Rosen PP. Pseudoangiomatous stromal hyperplasia (PASH). A mammary stromal tumor with myofibroblastic differentiation. Am J Surg Pathol 1995; 19 (3) 270-277
  • 31 Gogas J, Sechas M, Skalkeas G. Surgical management of diseases of the adolescent female breast: a clinicopathologic study. Am J Surg 1979; 137 (5) 634-637
  • 32 Berg WA, Sechtin AG, Marques H, Zhang Z. Cystic breast masses and the ACRIN 6666 experience. Radiol Clin North Am 2010; 48 (5) 931-987
  • 33 Huneeus A, Schilling A, Horvath E, Pinochet M, Carrasco O. Retroareolar cysts in the adolescent. J Pediatr Adolesc Gynecol 2003; 16 (1) 45-49
  • 34 Linda A, Zuiani C, Lorenzon M , et al. The wide spectrum of hyperechoic lesions of the breast. Clin Radiol 2011; 66 (6) 559-565
  • 35 Leibman AJ, Misra M, Castaldi M. Breast abscess after nipple piercing: sonographic findings with clinical correlation. J Ultrasound Med 2011; 30 (9) 1303-1308
  • 36 Stavros AT. Nonmalignant Breast Disorders that Have Complex Cystic Phases. Philadelphia, PA: Lippincott Williams & Wilkins; 2004
  • 37 Pettinato G, Manivel JC, Kelly DR, Wold LE, Dehner LP. Lesions of the breast in children exclusive of typical fibroadenoma and gynecomastia. A clinicopathologic study of 113 cases. Pathol Annu 1989; 24 (Pt 2) 296-328
  • 38 Welch ST, Babcock DS, Ballard ET. Sonography of pediatric male breast masses: gynecomastia and beyond. Pediatr Radiol 2004; 34 (12) 952-957
  • 39 Tominaga J, Hama H, Kimura N, Takahashi S. Magnetic resonance imaging of intraductal papillomas of the breast. J Comput Assist Tomogr 2011; 35 (1) 153-157
  • 40 Rosen PP, Cantrell B, Mullen DL, DePalo A. Juvenile papillomatosis (Swiss cheese disease) of the breast. Am J Surg Pathol 1980; 4 (1) 3-12
  • 41 Rosen PP, Lyngholm B, Kinne DW, Beattie Jr EJ. Juvenile papillomatosis of the breast and family history of breast carcinoma. Cancer 1982; 49 (12) 2591-2595
  • 42 Sanguinetti A, Fioriti L, Brugia M , et al. Juvenile papillomatosis of the breast in young male: a case report. G Chir 2011; 32 (8-9) 374-375
  • 43 Mussurakis S, Carleton PJ, Turnbull LW. Case report: MR imaging of juvenile papillomatosis of the breast. Br J Radiol 1996; 69 (825) 867-870
  • 44 Tan H, Zhang S, Liu H , et al. Imaging findings in phyllodes tumors of the breast. Eur J Radiol 2012; 81 (1) e62-e69
  • 45 Tan PH, Thike AA, Tan WJ , et al; Phyllodes Tumour Network Singapore. Predicting clinical behaviour of breast phyllodes tumours: a nomogram based on histological criteria and surgical margins. J Clin Pathol 2012; 65 (1) 69-76
  • 46 Cole-Beuglet C, Soriano R, Kurtz AB, Meyer JE, Kopans DB, Goldberg BB. Ultrasound, x-ray mammography, and histopathology of cystosarcoma phylloides. Radiology 1983; 146 (2) 481-486
  • 47 Wurdinger S, Herzog AB, Fischer DR , et al. Differentiation of phyllodes breast tumors from fibroadenomas on MRI. AJR Am J Roentgenol 2005; 185 (5) 1317-1321
  • 48 Guillot E, Couturaud B, Reyal F , et al; Breast Cancer Study Group of the Institut Curie. Management of phyllodes breast tumors. Breast J 2011; 17 (2) 129-137
  • 49 Atalla MA, Rozen WM, Grinsell D, Hyett A, Prakash S, Cham A. Recurrent phyllodes tumor of the breast: defining the role for skin-sparing mastectomy and autologous reconstruction. J Reconstr Microsurg 2011; 27 (4) 267-272
  • 50 Briggs RM, Walters M, Rosenthal D. Cystosarcoma phyllodes in adolescent female patients. Am J Surg 1983; 146 (6) 712-714
  • 51 Ben Hassouna J, Damak T, Gamoudi A , et al. Phylloides tumors of the breast: a case series of 106 patients. Am J Surg 2006; 192 (2) 141-147
  • 52 Karl SR, Ballantine TV, Zaino R. Juvenile secretory carcinoma of the breast. J Pediatr Surg 1985; 20 (4) 368-371
  • 53 Murphy JJ, Morzaria S, Gow KW, Magee JF. Breast cancer in a 6-year-old child. J Pediatr Surg 2000; 35 (5) 765-767
  • 54 Venta LA, Dudiak CM, Salomon CG, Flisak ME. Sonographic evaluation of the breast. Radiographics 1994; 14 (1) 29-50
  • 55 Glazebrook KN, Magut MJ, Reynolds C. Angiosarcoma of the breast. AJR Am J Roentgenol 2008; 190 (2) 533-538
  • 56 Liberman L, Dershaw DD, Kaufman RJ, Rosen PP. Angiosarcoma of the breast. Radiology 1992; 183 (3) 649-654
  • 57 Bae SY, Choi MY, Cho DH, Lee JE, Nam SJ, Yang JH. Large clinical experience of primary angiosarcoma of the breast in a single Korean medical institute. World J Surg 2011; 35 (11) 2417-2421
  • 58 Yang WT, Hennessy BT, Dryden MJ, Valero V, Hunt KK, Krishnamurthy S. Mammary angiosarcomas: imaging findings in 24 patients. Radiology 2007; 242 (3) 725-734
  • 59 Binokay F, Soyupak SK, Inal M, Celiktas M, Akgül E, Aksungur E. Primary and metastatic rhabdomyosarcoma in the breast: report of two pediatric cases. Eur J Radiol 2003; 48 (3) 282-284
  • 60 Birjawi GA, Haddad MC, Tawil AN, Khoury NJ. Metastatic rhabdomyosarcoma to the breast. Eur Radiol 2001; 11 (4) 555-558
  • 61 Perlet C, Sittek H, Forstpointner R, Kessler M, Reiser M. Metastases to the breast from rhabdomyosarcoma: appearances on MRI. Eur Radiol 1999; 9 (6) 1113-1116
  • 62 Chateil JF, Arboucalot F, Pérel Y, Brun M, Boisserie-Lacroix M, Diard F. Breast metastases in adolescent girls: US findings. Pediatr Radiol 1998; 28 (11) 832-835
  • 63 Boothroyd A, Carty H. Breast masses in childhood and adolescence. A presentation of 17 cases and a review of the literature. Pediatr Radiol 1994; 24 (2) 81-84
  • 64 West KW, Rescorla FJ, Scherer III LR, Grosfeld JL. Diagnosis and treatment of symptomatic breast masses in the pediatric population. J Pediatr Surg 1995; 30 (2) 182-186 , discussion 186–187