What is the role of ultrasonography in the diagnosis of pediatric breast disorders?

Updated: Apr 01, 2019
  • Author: Harsh Grewal, MD, FACS, FAAP; Chief Editor: Robert K Minkes, MD, PhD  more...
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Answer

Because of the density of the breast tissue in young children, mammography is not usually very helpful. [43] US is more effective at delineating masses within the immature breast. [44] Color Doppler US may increase the specificity of the diagnosis: Cysts are avascular, fibroadenomas are hypovascular, and abscesses show increased peripheral flow. [45]

Data suggest that US findings alone may guide management in most cystic and solid-cystic lesions. [46] Fine-needle aspiration (FNA) may be performed to manage breast cysts [47] ; US should be performed often to ensure that normal breast tissue is not harmed.

The Breast Imaging-Reporting and Data System (BI-RADS), which was developed in adult patients to determine the risk of cancer, is currently used in the pediatric population but may not be fully applicable to these patients. [48]  A study by Koning et al demonstrated that BI-RADS grossly overestimated the risk of malignancy in the pediatric population.


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