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01-06-2017 | Breast Oncology

Breast Malignancies in Children: Presentation, Management, and Survival

Authors: Morgan K. Richards, MD, MPH, Adam B. Goldin, MD, MPH, FACS, Elizabeth A. Beierle, MD, John J. Doski, MD, Melanie Goldfarb, MD, Monica Langer, MD, Jed G. Nuchtern, MD, Sanjeev Vasudevan, MD, Kenneth W. Gow, MD, FACS, Sara H. Javid, MD, FACS

Published in: Annals of Surgical Oncology | Issue 6/2017

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.

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Title: Breast Malignancies in Children: Presentation, Management, and Survival
Authors: Morgan K. Richards, MD, MPH
Adam B. Goldin, MD, MPH, FACS
Elizabeth A. Beierle, MD
John J. Doski, MD
Melanie Goldfarb, MD
Monica Langer, MD
Jed G. Nuchtern, MD
Sanjeev Vasudevan, MD
Kenneth W. Gow, MD, FACS
Sara H. Javid, MD, FACS
Publication date: 01-06-2017
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 6/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-016-5747-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Breast Malignancies in Children: Presentation, Management, and Survival

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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