Analysis of factors predicting surgical intervention and associated costs in pediatric breast masses: a single center study

Purpose Finding a breast mass in a child provokes apprehension in parents, especially in those with a family history of breast cancer. Clinicians must decide between serial imaging or biopsy of the mass. Herein, we identify management differences in those with and without a positive family history,...

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Bibliographic Details
Published in:Pediatric surgery international 2018-06, Vol.34 (6), p.679-685
Main Authors: Englert, E. Graham, Ares, Guillermo, Henricks, Andrea, Rychlik, Karen, Hunter, Catherine J.
Format: Article
Language:English
Subjects:
Adolescent
Age Factors
Biopsy - economics
Breast - pathology
Breast cancer
Breast Neoplasms - economics
Child
Child, Preschool
Cost-Benefit Analysis
Family medical history
Female
Genetic Predisposition to Disease
Health risk assessment
Humans
Male
Medicine
Medicine & Public Health
Original Article
Pediatric Surgery
Pediatrics
Retrospective Studies
Sex Factors
Surgery
Ultrasonic imaging
Ultrasonography, Mammary - economics
United States
Watchful Waiting
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Summary:Purpose Finding a breast mass in a child provokes apprehension in parents, especially in those with a family history of breast cancer. Clinicians must decide between serial imaging or biopsy of the mass. Herein, we identify management differences in those with and without a positive family history, as well as identify cost differences. Methods An institutional retrospective review was performed of patients (2–18 years of age) with a diagnosis of breast mass. Patient demographics, presentation, medical and surgical history, physical exam, imaging, and pathologic diagnosis were collected. Cost data were acquired from the pediatric health information system (PHIS). Costs were compared between patients managed by biopsy versus serial ultrasounds. Bivariate analyses including Pearson’s Chi-square, student’s t tests, and logistic regression were performed. Results The probability of biopsy increases with age ( p  = 0.0001) and female gender ( p  = 0.006). Biopsy rate is higher for larger masses ( p  
ISSN:0179-0358
1437-9813
DOI:10.1007/s00383-018-4268-7