Breast Malignancies in Children: Presentation, Management, and Survival.
Document Type
Article
Publication Date
6-1-2017
Publication Title
Annals of surgical oncology : the official journal of the Society of Surgical Oncology
Keywords
Adolescent; Adult; Aged; Aged, 80 and over; Breast Neoplasms; Carcinoma, Ductal, Breast; Carcinoma, Lobular; Child; Child, Preschool; Combined Modality Therapy; Disease Management; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Middle Aged; Neoplasm Invasiveness; Prognosis; Retrospective Studies; Sarcoma; Survival Rate; Young Adult
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.
Clinical Institute
Cancer
Department
Oncology
Department
Surgery
Recommended Citation
Richards, Morgan K; Goldin, Adam B; Beierle, Elizabeth A; Doski, John J; Goldfarb, Melanie; Langer, Monica; Nuchtern, Jed G; Vasudevan, Sanjeev; Gow, Kenneth W; and Javid, Sara H, "Breast Malignancies in Children: Presentation, Management, and Survival." (2017). Articles, Abstracts, and Reports. 2362.
https://digitalcommons.providence.org/publications/2362
