Outcomes of a joint paediatric breast clinic: an observational case series

Objective Female paediatric patients with breast symptoms may see a range of specialists with varying expertise and experience in managing their condition. There is a paucity of evidence to guide diagnosis and treatment. We report our joint paediatric breast clinic experience to describe the spectrum of symptoms and outcomes, with follow-up, in female paediatric patients presenting with breast-related symptoms. Method A retrospective review of clinical records of all females (<18 years) seen between December 2017 and December 2023 in a joint paediatric/surgical breast clinic was conducted. Symptoms, investigations, interventions, outcomes and histological diagnoses were reviewed. Results 152 patients were included: 116 (76.3%) with breast lump-related symptoms (group A) and 36 (23.7%) with other non-lump breast-related symptoms (group B). In group A, 112/116 (97%) patients underwent ultrasound evaluation. The most common diagnoses were normal breast tissue (52; 45%) and fibroadenoma (FA) (40; 35%). 13 (11%) patients underwent excision for presumed FA, all confirmed benign FA with no complications. Another eight (7%) patients re-presented after discharge; four had excision, all benign FAs. In group B, the most common clinical diagnosis was breast asymmetry 17/36 (47%). Two patients re-presented, with one having a diagnosis of FA supported by fine needle aspiration. Overall, 22 (15%) patients required onward referral/investigations for symptoms unrelated to their breast symptoms. Conclusion No malignant lesion was diagnosed in this cohort of patients, and surgery was performed in 15% of those presenting with a breast lump. Paediatrician and breast surgeon collaboration facilitated the identification and referral of non-breast symptoms, supporting adoption of this model.