Purpose or Case Report: A trend of increased utilization of pediatric breast ultrasound has been suggested in our pediatric healthcare system. Despite this perceived increase in cases, the number of concerning breast findings in our population remains extremely low. Our hypothesis is that there has been significant increase in the number of pediatric breast ultrasounds, yet examinations remain overwhelmingly benign.
Methods & Materials: We conducted an IRB approved retrospective review of sonographic breast exams in children less than 18 years of age at our institution from 2005-2015. Data on referring physician specialty, patient age and gender, reason for study, and sonographic characterization of lesions were recorded. Additionally, we documented follow up for the masses found on sonography. Pathology for lesions that were surgically managed was also obtained.
Results: Over a period of 10 years, the use of breast ultrasound has increased at our institution over 400%, with the highest utilization in the most recent year, 2015. In 2015 alone, 89% of studies were ordered by pediatricians. In that year, over half of the studies were read as entirely normal, with only 5% proceeding to surgical management. Most common surgical pathology consisted of abscess, fibroadenoma, gynecomastia and pseudoangiomatous stromal hyperplasia.
Conclusions: Our study confirms the significant increase in utilization of pediatric breast sonography for benign conditions. This complements findings of other recent studies, which conclude breast cancer in the pediatric population is exceedingly rare and masses found on ultrasound are overwhelming benign. Our study should reassure pediatricians, pediatric surgeons, and parents that clinical follow up is sufficient in the majority of patients and ultrasound is only indicated in a focused subset.