Nguyen Derek,  Dunn Emily

Final Pr. ID: Poster #: SCI-014

Children and young adults can present with breast complaints in the emergency setting and ultrasound is typically the initial imaging modality of choice for work-up. While many sonographic findings are benign, there are rare presentations of indeterminate and suspicious masses. In these cases, radiologists and clinicians involved in these patient's care may be unfamiliar with the diagnosis and management of lesions that warrant follow-up with dedicated breast imagers. This study is designed to analyze the common characteristics of pediatric breast complaints from the emergency department and if follow-up care was recommended and pursued. Read More

Authors:  Nguyen Derek , Dunn Emily

Keywords:  Emergency, Breast, Ultrasound

Gleason Miranda,  Moredock Elisabeth,  Parish David,  Pfeifer Cory

Final Pr. ID: Poster #: SCI-021

The practice of performing dedicated breast ultrasounds in the pediatric emergency department varies according to institution. In the adult population, breast ultrasounds are commonly interpreted by dedicated breast imagers and/or radiologists appropriately qualified to interpret mammograms. Children's hospitals with dedicated pediatric radiology faculty are less likely to have such individuals on staff. This paper examines the practice of breast ultrasounds ordered in the emergency department throughout a large children's health system. Read More

Authors:  Gleason Miranda , Moredock Elisabeth , Parish David , Pfeifer Cory

Keywords:  Breast Abscess, Breast Ultrasound, Emergency Radiology

Nguyen Derek,  Dunn Emily

Final Pr. ID: Poster #: EDU-063

Children and young adults occasionally present with breast complaints in the emergency setting, typically with palpable abnormalities or pain. Ultrasound is the imaging of modality of choice in this setting due to its wide availability, resolution for superficial soft tissue structures, and lack of ionizing radiation. In this presentation, we review breast lesions seen in children and young adults undergoing sonographic evaluation in the emergency department at a tertiary pediatric hospital with the final diagnosis. The aim of this exhibit is to review pediatric breast anatomy and depict representative ultrasound imaging features of normal variants, benign lesions, and findings which should raise suspicion for malignancy. Cases will include but not limited to: premature glandular tissue, ductal ectasia, breast edema, breast cellulitis, breast abscess, periductal mastitis, complicated cyst, intraductal papilloma, fibroadenoma, phyllodes tumor, and breast cancer. Read More

Authors:  Nguyen Derek , Dunn Emily

Keywords:  Emergency, Breast, Ultrasound

Saini Rimpi,  Wermers Joshua,  Larson Shelby,  Mitchell Grace,  Patel Amy

Final Pr. ID: Poster #: EDU-093

With an incidence of 3.25%, breast masses in the pediatric population are a relatively rare phenomenon. Despite this, breast masses are a substantial source of anxiety and concern for parents and patients alike, largely due to the increased awareness of breast cancer in the adult population. Fortunately, the vast majority of masses are benign, and pediatric breast malignancies constitute less than 1% of all pediatric malignancies. Moreover, malignancy tends to be secondary to metastatic disease from lymphoma, leukemia, or rhabdomyosarcoma, as primary breast carcinoma is exceedingly rare. Although initial sonographic characteristics of breast masses may be nonspecific, recommendation for further evaluation with biopsy and/or excision of the mass is usually not recommended due to the rarity of malignancy, and avoidance of disrupting immature breast parenchymal tissue. In adults, the Breast Imaging-Reporting and Data System classification is quite accurate for dictating management recommendations. However, this system grossly over-emphasizes the risk of malignancy in pediatric patients, as imaging findings are usually discordant with histology. Currently, there are no standardized guidelines for management recommendations of pediatric breast masses, and short-term follow-up ultrasound is usually recommended to evaluate for malignant potential. The purpose of this educational exhibit is to compare the sonographic abnormalities of breast pathologies arising from normal breast development, including but not limited to gynecomastia, mastitis, and abscesses, from those arising from neoplastic processes including fibroadenomas, hemangiomas, arterio-venous malformations, and phyllodes tumors. In addition, the current literature on management recommendations, including indications for MRI and biopsy/excision of breast masses, will be reviewed. Finally, this exhibit will discuss the important role pediatric radiologists play in understanding the epidemiology and natural history of breast pathologies, enabling accurate characterization of masses and appropriate treatment recommendations to further guide patient management. Read More

Authors:  Saini Rimpi , Wermers Joshua , Larson Shelby , Mitchell Grace , Patel Amy

Keywords:  Breast, Ultrasound, hemangioma