Pediatric and adolescent breast masses: surgical experience and observations on possible hormonal influences

Breast masses in pediatric and adolescent patients are uncommon and predominantly benign; however, they often cause considerable anxiety for patients and their families. This study aimed to evaluate the clinical characteristics, diagnostic processes, histopathological distribution, and surgical outcomes of surgically treated breast masses, and to investigate the potential role of hormonal factors. Female patients aged 0–18 years who underwent surgical excision for breast masses between 2014 and 2023 were retrospectively analyzed. Clinical findings, imaging features, surgical indications, histopathological diagnoses, and postoperative outcomes were evaluated. Ultrasonography was used as the primary imaging modality. Among 118 patients, 24 underwent surgery and 25 masses were excised. The mean age was 15.24 ± 1.67 years, and the mean mass size was 4.68 ± 1.49 cm, excluding a giant phyllodes tumor (>15 cm) that was treated as a statistical outlier. Fibroadenoma was the most common diagnosis (80%). No malignancy was detected. Ovarian cysts were present in 33.3% of patients without significant association with lesion characteristics. No complications or recurrences were observed. Breast masses in pediatric and adolescent patients are predominantly benign. Ultrasonography served as an effective primary imaging modality, and surgical treatment was safe when appropriately indicated. A possible hormonal contribution to lesion development could not be confirmed or excluded by this study and remains an exploratory observation warranting further investigation.