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Ann Surg Oncol. 2017 Jun;24(6):1482-1491. doi: 10.1245/s10434-016-5747-5. Epub 2017 Jan 5.

Breast Malignancies in Children: Presentation, Management, and Survival.

Author information

1
Department of Surgery, University of Washington, Seattle, WA, 98195, USA. morgan.richards@gmail.com.
2
Department of General and Thoracic Surgery, Seattle Children's Hospital, Seattle, WA, 98195, USA. morgan.richards@gmail.com.
3
Division of Pediatric General and Thoracic Surgery, Seattle Children's Hospital, Seattle, WA, 98105, USA. morgan.richards@gmail.com.
4
Department of General and Thoracic Surgery, Seattle Children's Hospital, Seattle, WA, 98195, USA.
5
University of Alabama, Birmingham, Birmingham, AL, 35233, USA.
6
Methodist Children's Hospital of South Texas, San Antonio, TX, 78229, USA.
7
John Wayne Cancer Institute, Santa Monica, CA, 90404, USA.
8
Maine Children's Cancer Program, Scarborough, ME, 04074, USA.
9
Baylor College of Medicine, Houston, TX, 77030, USA.
10
Department of Surgery, University of Washington, Seattle, WA, 98195, USA.

Abstract

PURPOSE:

Pediatric breast malignancies are rare, and descriptions in the literature are limited. The purpose of our study was to compare pediatric and adult breast malignancy.

METHODS:

We performed a retrospective cohort study using the National Cancer Data Base comparing patients ≤21 years to those >21 years at diagnosis (1998-2012). Generalized linear models estimated differences in demographic, tumor, and treatment characteristics. Cox regression was used to compare overall survival.

RESULTS:

Of 1,999,181 cases of invasive breast malignancies, 477 (0.02%) occurred in patients ≤21 years. Ninety-nine percent of adult patients had invasive carcinoma compared with 64.8% of pediatric patients with the remaining patients having sarcoma, malignant phyllodes, or malignancy not otherwise specified (p < 0.001). Pediatric patients were twice as likely to have an undifferentiated malignancy [relative risk (RR) 2.19; 95% confidence interval (CI) 1.72-3.79]. Half of adults presented with Stage I disease compared with only 22.7% of pediatric patients (p < 0.001). Pediatric patients were 40% more likely to have positive axillary nodes (RR 1.42; 95% CI 1.10-1.84). Among patients with invasive carcinoma, pediatric patients were more than four times as likely to receive a bilateral than a unilateral mastectomy compared with adults (RR 4.56; 95% CI 3.19-6.53). There was no difference in overall survival between children and adults.

CONCLUSIONS:

Pediatric breast malignancies are more advanced at presentation, and there is variability in treatment practices. Adult and pediatric patients with invasive carcinoma have similar overall survival.

PMID:
28058544
DOI:
10.1245/s10434-016-5747-5
[Indexed for MEDLINE]

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