Salazar VG, Adame CJE

Language: Spanish
References: 12
Page: 22-29
PDF size: 183.66 Kb.

ABSTRACT

Benign breast tumors are the most frequent breast pathology in adolescents, most of which correspond to simple breast fibroadenomas. There is no consensus regarding their surgical management; however, the most commonly used approach is simple excision of the lesion, regardless of the aesthetic outcomes it may cause.
Clinical case: A 12-year-old female, accompanied by her guardian (mother), with no clinically relevant medical history, was referred to the breast clinic due to a left breast tumor associated with mastalgia. Physical examination revealed asymmetric breasts due to a lesion in the left breast, which involved the entire upper quadrants, measuring approximately 8 × 7 cm, and was painful on mobilization. The lymph node chain showed no alterations. Institutional ultrasound demonstrated a left breast tumor in the upper outer and inner quadrants, with lobulated margins, heterogeneous predominantly hypoechoic echotexture, posterior acoustic shadowing, and central and peripheral vascularity on Doppler, measuring 66 × 52 × 62 mm, consistent with a probable fibroadenoma, BI-RADS 3. A core needle biopsy of the lesion was performed in the outpatient setting; the sample was sent to pathology, and one week later the result was obtained, reporting a fibroepithelial neoplasm compatible with juvenile fibroadenoma. Usual ductal hyperplasia. Negative for malignancy in the examined material. Surgery was scheduled; excision of the lesion was performed using a horizontal branch mammoplasty technique, and a multilobulated tumor measuring approximately 6 × 5 cm was removed. The definitive pathology report confirmed the diagnosis of juvenile fibroadenoma. At the 10-day postoperative follow-up, symmetry of both breasts was observed, with good incision healing and an excellent aesthetic result.
Juvenile fibroadenoma has a mean age of onset of 15 years; its etiology is associated with an excessive response to estrogens; however, it may occur in patients without prior menarche. It is mainly differentiated from conventional fibroadenoma by its rapid growth and, histologically, by increased stromal cellularity; its main differential diagnosis is phyllodes tumor. The treatment of choice is simple resection; although no standardized treatment exists, surgical techniques aimed at preserving breast anatomy regardless of lesion size have been described, and are preferred due to lower complication rates and better aesthetic outcomes, which have a significant impact on adolescents.

REFERENCES

1. Rainsbury RM. Surgery insight: oncoplastic breast-conservingreconstruction—indications, benefits, choices andFigura 5. Cicatriz quirúrgica a las 4 semanas de lacirugía con técnica oncoplásticaFoto: G. Salazar Vega y J. E Adame Caballeroloutcomes. Nat Clin Pract Oncol. 2007;4(11):657-664.doi:10.1038/ncponc0957.

2. Lombardo-Aburto E, Gayón-Vera E. Procedimiento diagnósticoy terapéutico en la adolescente con tumores de lamama. Acta Pediatr Mex. 2021;42(3):149-153.

3. Boudaoud N, Raimond E, Pouzet L, Correia N, Bouche-Pillon MA, Birembaut P, et al. Patología mamaria de laadolescente. EMC Ginecol Obstet [Internet]. 2019 [citado2025 oct 20];55(4):1-20. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S1283081X19430142

4. Schiavon E, Jiménez C, Robayo C, Ruano M, Calderón C,Morales R, et al. Nódulos mamarios en la adolescencia. ActaPediatr Mex [Internet]. 2001 [citado 2025 oct 20];22(3):80-88. Disponible en: http://repositorio.pediatria.gob.mx:8180/bitstream/20.500.12103/1964/1/ActPed2001_55.pdf

5. Sánchez Arenas M, Álvarez-Díaz C, Durán-Cárdenas C,et al. La técnica correcta para la exploración de mama.Rev Fac Med UNAM [Internet]. 2018 [citado 2025 oct20];61(2):44-50. Disponible en: https://www.medigraphic.com/pdfs/facmed/un-2018/un182i.pdf

6. Corredor Andrés B, Márquez Rivera M, Lobo Bailón F,González Meli B, Azorín Cuadrillero D, Muñoz CalvoMT, et al. Fibroadenoma gigante de mama en adolescentes:procedimientos diagnóstico-terapéuticos. An Pediatr(Engl Ed) [Internet]. 2018;89(6):383-385. doi:10.1016/j.anpedi.2018.01.006

7. Soriano-Benítez M, Acea-Nebril B, Morales-PalomaresMA. Oncoplastía: nuevos abordajes quirúrgicos en cirugíaconservadora de mama, en México. Ginecol Obstet Mex.2014;82(1):20-27.

8. Vico Marín I, Almazán Fernández de Bobadilla MV. Ectasiaductal: diferentes formas de expresión según la edad. Rev PediatrAten Primaria [Internet]. 2025;27:59-65. Disponible en:https://www.pap.es/articulo.php?lang=es&id=14285&term1

9. Acea-Nebril B, López S, Cereijo C, Bazarra A, Pais P,Uriarte I, et al. Impacto asistencial de las técnicas oncoplásticasconservadoras en un programa quirúrgicopara enfermas con cáncer de mama. Cir Esp [Internet].2005;78(3):175-182. Disponible en: https://www.elsevier.es/es-revista-cirugia-espanola-36-articulo-impacto-asistencial-las-tecnicas-oncoplasticas-13078301

10. Telich VJ, Carmona BE, Garza AD, Telich TJ, et al. Mastopexiaperiareolar tipo margarita. Cir Plást Ibero-Latinoam[Internet]. 2010;36(2):93-97. Disponible en: https://www.medigraphic.com/pdfs/cplast/cp-2010/cp102g.pdf

11. Acea BN. Cirugía oncoplástica conservadora en el cáncerde mama: indicaciones y límites en su aplicación. Cir Esp[Internet]. 2005 Jul;78(1):12-18. Disponible en: https://www.elsevier.es/es-revista-cirugia-espanola-36-articulocirugia-oncoplastica-conservadora-cancer-mama-indicaciones-limites-13076513

12. Association of Breast Surgery at BASO. Oncoplasticbreast surgery: a guide to good practice. Eur J Surg Oncol.2007;33 Suppl 1:S1-S23.