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BREAST DISORDERS IN CHILDREN
Category: Pediatric Surgery
Abstract : Most breast disorders in children of either sex are benign. Congenital lesions are: absent or multiple
breast. Transplacental hormonal influence in neonates may cause hyperplasia of breast tissue with
predisposition to infection (Mastitis neonatorum). Premature hyperplasia (thelarche) in females is the most
common breast lesion in children. It occurs before the age of eight as a disk-shaped con
Most breast disorders in children of either sex are benign. Congenital lesions are: absent or multiple
breast. Transplacental hormonal influence in neonates may cause hyperplasia of breast tissue with
predisposition to infection (Mastitis neonatorum). Premature hyperplasia (thelarche) in females is the most
common breast lesion in children. It occurs before the age of eight as a disk-shaped concentric asymptomatic
subareolar mass.
Remains static until changes occur in the opposite breast 6-12 mo later. It can regress
spontaneously or stay until puberty arrives. Biopsy may mutilate future breast development. On the contrary,
discrete breast masses in males cause concern and excision is warranted. Gynecomastia is breast enlargement
cause by hormonal imbalance, usually in obese pre-adolescent boys. If spontaneous regression does not
occur, it can be managed by simple mastectomy. Virginal hypertrophy is rapid breast enlargement after puberty
due to estrogen sensitivity. If symptomatic, management is reduction mammoplasty.
Breast enlargement is commonly seen in newborns babies, a condition associated with clear or milky
nipple discharge. Maternal hormones are considered the culprit. On rare occasions the mother of an infant will
bring to you the attention that the child is having intermittent episodes of bleeding through the nipple. In infants
it is a benign, self-limited condition that should be managed conservatively (it could take six months to go away).
The main reason of bloody nipple discharge is mammary ductal ectasia, which extends down to the collecting
tubules. Mammary duct ectasia was first reported in 1983, characterized by dilatation of the subareolar duct
system, and by inflammatory reaction and fibrosis. The infant's own endocrine system is responsible for breast
enlargement and mammary duct ectasia, though infection has also been postulated as etiologic factor. Surgical
procedures should be avoided, because injury to the breast bud may cause permanent damage. Stimulation
or massages to the breast should also be avoided. When associated with hypertrophied mammary glands,
prepubertal gynecomastia should be sought.
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