Breast Lesions in Children and Adolescents: Diagnosis and Management

Pediatric breast disease is uncommon, and primary breast carcinoma in children is extremely rare. Therefore, the approach used to address breast lesions in pediatric patients differs from that in adults in many ways. Knowledge of the normal imaging features at various stages of development and the characteristics of breast disease in the pediatric population can help the radiologist to make confident diagnoses and manage patients appropriately. Most breast diseases in children are benign or associated with breast development, suggesting a need for conservative treatment. Interventional procedures might affect the developing breast and are only indicated in a limited number of cases. Histologic examination should be performed in pediatric patients, taking into account the size of the lesion and clinical history together with the imaging findings. A core needle biopsy is useful for accurate diagnosis and avoidance of irreparable damage in pediatric patients. Biopsy should be considered in the event of abnormal imaging findings, such as non-circumscribed margins, complex solid and cystic components, posterior acoustic shadowing, size above 3 cm, or an increase in mass size. A clinical history that includes a risk factor for malignancy, such as prior chest irradiation, known concurrent cancer not involving the breast, or family history of breast cancer, should prompt consideration of biopsy even if the lesion has a probably benign appearance on ultrasonography.

Statistical and Histological Studies on HBsAg in Grade-School Childrens

A study on prevalence of hepatitis B surface antigen(HBsAg) in 1,292 grade-school children(548 of rural area, 744 of urban area) by Counterimmunoelectrophoretic method: various liver fuction tests and liver biopsy were performed, and the results obtained are as follows: 1) Fifty four of 1,292 children who were selected randomly were positive for HBsAg(4.2%) and incidence of HBsAg was higher in rural area(4.6%) than in urban area(3.9%). 2) The incidence of HBsAg was higher in male children(4.5%) than female Children(3.7%). 3) Age distribution revealed highest incidence at 10(5.9%), years old lowest incidence at 9(2.9%), but any significant interrelationship wasn't found between ages. 4) The order of liver function tests which showed abnormal values by numver are as follows: GGT(26.2%), SGOT(23.6%), Total protein(7.1%), SGPT(4.8%), TTT(4.8%), BSP retention test(2.4%), PT(0%). The values of GGT and SGOT were thought to be most useful in HBsAg positive children. 5) All tests showed normal values in 22 children(52.4%), one test and more than 2 tests showed abnormal values each in 18 children(42.8%) and in 2 children(4.8%). 6) On liver biopsy performed in nine HBsAg positive children, one showed normal liver tissue, two showed mild hepatocellular degenerative change, five showed chronic persistent hepatitis and showed chronic active hepatitis. On orcein staining, three showed intracytoplasmic inclusion bodies thought to be HBsAg.