Breast disorders

Abstract Breast disorders in children have many causes, but developmental abnormalities are the most common. This chapter outlines the embryological development of the breast, breast development at puberty, congenital abnormalities of the breast, and development abnormalities of the breast. Congenital abnormalities include amastia (with a common cause being Poland syndrome), polymastia, and tuberous breasts. Although tuberous breasts are congenital, they become evident during puberty, as do the developmental abnormalities. These conditions present challenges in management due to the psychological impact, particularly during adolescence. It is important that no surgical intervention is undertaken until the breasts are fully developed and patients and families are counselled appropriately. The chapter also covers the benign and malignant neoplasms of the breast. Fibroadenoma is the most common cause of a breast lump in adolescent girls. All discrete lumps in children must be assessed by breast ultrasonography, and biopsy (by an experienced clinician) is indicated for those with a doubtful aetiology on the scan. Management of breast lesions requires input from specialist breast and paediatric teams.