Öz
Objectives: To evaluate the surgical approach to pediatric breast masses.Patients and Methods: Patients who underwent a surgical intervention due to breast mass between the years of 2005-2017 were evaluated retrospectively. They were evaluated in terms of age, primary diagnosis, radiological characteristics, surgical treatment method, complications, length of hospital stay and follow-up.Results: The mean age of the 29 cases that were operated on for a breast mass was 14.86 years 6-17 years . The most common complaint at admission was a palpable breast mass. Two cases had bloody discharge from the nipple. The mean duration of the symptoms was 32.3 weeks 2 weeks-1 year . Six cases 20.6% had a family history associated with breast disease. The mean BMI was 18.8 . In 15 patients, the mass was in the left breast, whereas in 13 patients, the mass was in the right breast. However, in one case, two masses were localized bilaterally.Regarding radiological examination, ultrasonography USG was performed on all patients while magnetic resonance imaging MRI was obtained as a supplement in five cases. The mean size of the masses measured radiologically was 2.9 cm 0.9-7 cm . There were multiple lesions in five cases. Needle biopsy was performed in six cases with the suspicion of malignancy in the preoperative period, and they were all found to be consistent with fibroadenoma.Histopathological examination was performed after the surgical excision and revealed fibroadenoma n:26 , borderline phylloides n: 1 , nipple adenoma n: 1 and galactocele n: 1 .The mean follow-up period was 36.6 months 3 months-10 years . New lesions were developed ipsilaterally in three cases and contralaterally in one case during follow-up. Conclusion: Most of pediatric breast masses are benign. Although malignancy is rarely encountered, MRI and needle biopsy are required for accurate surgical planning in case of suspicious ultrasonography findings
Anahtar Kelimeler
Kaynakça
- Knell J, Koning JL, Grabowski JE. Analysis of surgically excised breast masses in 119 pediatric patients. Pediatr Surg Int. 2016;32:93-6. [CrossRef]
- Tiryaki T, Senel E, Hucumenoglu S, Cakir BC, Kibar AE. Breast fibroadenoma in female adolescents. Saudi Med J. 2007;28:137-8.
- Durmaz E, Öztek MA, Arıöz Habibi H, Kesimal U, Sindel HT. Breast diseases in children: the spectrum of radiologic findings in a cohort study. Diagn Interv Radiol. 2017;23:407-13. [CrossRef]
- Tea MK, Asseryanis E, Kroiss R, Kubista E, Wagner T. Surgical breast lesions in adolescent females. Pediatr Surg Int. 2009; 25:73-5. [CrossRef]
- Karadağ ÇA. Breast Masses in Chilhood. Turkiye Klinikleri J Pediatr Surg-Special Topics 2015;5:39-46
- Chao TC, Lo YF, Chen SC, Chen MF. Sonographic features of phyllodes tumors of the breast. Ultrasound Obstet Gynecol. 2002;20:64-71. [CrossRef]
- Kaneda HJ, Mack J, Kasales CJ, Schetter S. Pediatric and adolescent breast masses: a review of pathophysiology, imaging, diagnosis, and treatment. AJR Am J Roentgenol. 2013;200:204-12. [CrossRef]
- Ezer SS, Oguzkurt P, Ince E, Temiz A, Bolat FA, Hicsonmez A. Surgical treatment of the solid breast masses in female adolescents. J Pediatr Adolesc Gynecol. 2013;26:31-5. [CrossRef]
- Resetkova E, Khazai L, Albarracin CT, Arribas E. Clinical and radiologic data and core needle biopsy findings should dictate management of cellular fibroepithelial tumors of the breast. Breast J. 2010;16:573- 80. [CrossRef]
- Ciftci AO, Tanyel FC, Büyükpamukçu N, Hiçsönmez A. Female breast masses during childhood: a 25-year review. Eur J Pediatr Surg. 1998;8:67-70. [CrossRef]
- Komenaka IK, El-Tamer M, Pile-Spellman E, Hibshoosh H. Core needle biopsy as a diagnostic tool to differentiate phyllodes tumor from fibroadenoma. Arch Surg. 2003;138:987-90. [CrossRef]
- Chang DS, McGrath MH. Management of benign tumors of the adolescent breast. Plast Reconstr Surg. 2007;120:13-9. [CrossRef]
- Chen WH, Cheng SP, Tzen CY, Yang TL, Jeng KS, Liu CL, Liu TP. Surgical treatment of phyllodes tumors of the breast: retrospective review of 172cases. J Surg Oncol. 2005;91:185-94. [CrossRef]
Öz
Amaç: Çocukluk çağı meme kitlelerinde cerrahi yaklaşımın değerlendirilmesidir.Hastalar ve Yöntemler: 2005-2017 yılları arasında meme kitlesi nedeni ile cerrahi girişim yapılan olgular geriye dönük olarak incelendi. Yaş, primer tanı, radyolojik özellikler, cerrahi tedavi yöntemi, komplikasyonlar, hastanede kalış süresi ve takip açısından değerlendirildi.Bulgular: Memede kitle nedeniyle cerrahi yapılan 29 olgunun yaş ortalaması 14,86 yaş 6-17 yaş idi. En sık başvuru yakınması memede ele gelen kitle idi. İki olguda ayrıca kanlı meme başı akıntısı mevcuttu. Semptomların süresi ortalama 32,3 hafta 2 hafta-1 yıl olarak bulundu. Altı olguda %20,6 meme hastalığı ile ilgili aile hikayesi mevcuttu. Ortalama BMİ 18,8 idi. Lezyonların 15’i sol, 13’ü sağ ve 1’i bilateral yerleşimliydi.Radyolojik değerlendirme için olguların tümüne ultrasonografi USG , 5’ine ek olarak magnetik rezonans görüntüleme MRG yapıldı. Radyolojik olarak ölçülen kitle boyutu ortalama 2,9 cm 0,9-7 cm idi. Beş olguda birden fazla lezyon mevcuttu. Altı olguya malignite şüphesi ile preoperatif dönemde iğne biyopsisi yapıldı ve hepsi fibroadenom ile uyumlu bulundu.Cerrahi eksizyon sonrası yapılan histopatolojik incelemede fibroadenom n:26 , borderline filloides tümörü n:1 , meme başı duktus adenomu n:1 ve galaktosel n:1 saptandı.Ortalama takip zamanı 36,6 ay 3 ay-10 yıl idi. Takipte olguların 3’ünde aynı tarafta, 1’ünde karşı tarafta yeni lezyonlar ortaya çıktı ve takibe alındı. Sonuç: Çocukluk çağı meme kitlelerinin çoğu benigndir. Nadiren de olsa malignite görülmesi nedeniyle klinik muayene ve ultrasonografinin şüpheli olduğu olgularda MRG yapılması ve iğne biyopsisi alınması doğru cerrahi planlanma için gereklidir
Anahtar Kelimeler
Kaynakça
- Knell J, Koning JL, Grabowski JE. Analysis of surgically excised breast masses in 119 pediatric patients. Pediatr Surg Int. 2016;32:93-6. [CrossRef]
- Tiryaki T, Senel E, Hucumenoglu S, Cakir BC, Kibar AE. Breast fibroadenoma in female adolescents. Saudi Med J. 2007;28:137-8.
- Durmaz E, Öztek MA, Arıöz Habibi H, Kesimal U, Sindel HT. Breast diseases in children: the spectrum of radiologic findings in a cohort study. Diagn Interv Radiol. 2017;23:407-13. [CrossRef]
- Tea MK, Asseryanis E, Kroiss R, Kubista E, Wagner T. Surgical breast lesions in adolescent females. Pediatr Surg Int. 2009; 25:73-5. [CrossRef]
- Karadağ ÇA. Breast Masses in Chilhood. Turkiye Klinikleri J Pediatr Surg-Special Topics 2015;5:39-46
- Chao TC, Lo YF, Chen SC, Chen MF. Sonographic features of phyllodes tumors of the breast. Ultrasound Obstet Gynecol. 2002;20:64-71. [CrossRef]
- Kaneda HJ, Mack J, Kasales CJ, Schetter S. Pediatric and adolescent breast masses: a review of pathophysiology, imaging, diagnosis, and treatment. AJR Am J Roentgenol. 2013;200:204-12. [CrossRef]
- Ezer SS, Oguzkurt P, Ince E, Temiz A, Bolat FA, Hicsonmez A. Surgical treatment of the solid breast masses in female adolescents. J Pediatr Adolesc Gynecol. 2013;26:31-5. [CrossRef]
- Resetkova E, Khazai L, Albarracin CT, Arribas E. Clinical and radiologic data and core needle biopsy findings should dictate management of cellular fibroepithelial tumors of the breast. Breast J. 2010;16:573- 80. [CrossRef]
- Ciftci AO, Tanyel FC, Büyükpamukçu N, Hiçsönmez A. Female breast masses during childhood: a 25-year review. Eur J Pediatr Surg. 1998;8:67-70. [CrossRef]
- Komenaka IK, El-Tamer M, Pile-Spellman E, Hibshoosh H. Core needle biopsy as a diagnostic tool to differentiate phyllodes tumor from fibroadenoma. Arch Surg. 2003;138:987-90. [CrossRef]
- Chang DS, McGrath MH. Management of benign tumors of the adolescent breast. Plast Reconstr Surg. 2007;120:13-9. [CrossRef]
- Chen WH, Cheng SP, Tzen CY, Yang TL, Jeng KS, Liu CL, Liu TP. Surgical treatment of phyllodes tumors of the breast: retrospective review of 172cases. J Surg Oncol. 2005;91:185-94. [CrossRef]
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Research Article |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Haziran 2020 |
| Yayımlandığı Sayı | Yıl 2020Sayı: 2 |