🎀 Chapter 588 · Breast Health: Breast Masses

Nelson Textbook of Pediatrics 22nd Edition — Focus on breast masses in children and adolescents. Fibroadenoma (most common solid mass, 2-3 cm, rubbery, mobile). Juvenile/giant fibroadenoma (>5 cm, rapid growth). Phyllodes tumor (sarcoma, requires wide excision). Ultrasound is imaging of choice. Observation for small stable fibroadenomas. Excision for >5 cm, rapid growth, complex features, or patient anxiety.

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📋 30 Clinical Scenarios — Breast Masses (Chapter 588)

📇 High‑Yield Review Cards: Breast Masses

🩺 Clinical Approach to Palpable Breast Mass

Select a breast mass presentation for diagnostic approach.

📋 Stepwise Algorithm: Evaluation & Management of Breast Masses

🔑 Key Principles (Nelson Ch.588 — Breast Masses)
• Fibroadenoma: Most common solid mass (60-80%). Well-circumscribed, rubbery, mobile, painless.
• Ultrasound is imaging of choice: No mammography in pediatrics.
• Observation recommended: For classic fibroadenoma <5 cm, non-growing, benign features.
• Excision indications: Size >5 cm, rapid growth (doubling in 3-6 months), complex US features, patient/family anxiety, symptomatic.
• Juvenile (giant) fibroadenoma: >5 cm, rapidly growing, hypercellular histology; excise.
• Phyllodes tumor: Sarcoma; excise with 1 cm margins; recurrence possible.

    ⚡ Reflex Prompts — Breast Mass Clinical Decisions

    📖 Summary: Breast Masses in Children & Adolescents