Adult BI-RADS risk estimates overstate cancer risk in pediatric breast masses

In 279 excised breast lesions in patients under 20, none were malignant and 87% were fibroadenomas, yet 55% were Breast Imaging Reporting and Data System (BI-RADS) 4—adult estimates overpredict pediatric cancer risk.

• Retrospective single-center review of 279 pediatric breast lesion excisions (217 with preoperative BI-RADS) identified no malignancies; fibroadenomas accounted for 87% of lesions (n=263).
• Among patients with BI-RADS scores, 55% were assigned BI-RADS 4 and 15.4% BI-RADS 3 despite overwhelmingly benign pathology.
• Among 44 patients with multiple lesions, 97.7% had at least one fibroadenoma.

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