Breast Imaging-Reporting and Data System (BI-RADS) classification in 51 excised palpable pediatric breast masses

Jeffrey L. Koning, Katherine P. Davenport, Patricia S. Poole, Peter G. Kruk, Julia E. Grabowski

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Introduction: The American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) classification was developed to risk stratify breast lesions and guide surgical management based on imaging. Previous studies validating BI-RADS for US do not include pediatric patients. Most pediatric breast masses present as palpable lesions and frequently undergo ultrasound, which is often accompanied with a BI-RADS classification. Our study aimed to correlate BI-RADS with pathology findings to assess applicability of the classification system to pediatric patients. Methods: We performed a retrospective review of all patients who underwent excision of a breast mass at a single center from July 2010 to November 2013. We identified all patients who underwent preoperative ultrasound with BI-RADS classification. Demographic data, imaging results, and surgical pathology were analyzed and correlated. Results: A total of 119 palpable masses were excised from 105 pediatric patients during the study period. Of 119 masses, 81 had preoperative ultrasound, and BI-RADS categories were given to 51 masses. Of these 51, all patients were female and the average age was 15.9 years. BI-RADS 4 was given to 25 of 51 masses (49%), and 100% of these lesions had benign pathology, the most common being fibroadenoma. Conclusions: Treatment algorithm based on BI-RADS classification may not be valid in pediatric patients. In this study, all patients with a BI-RADS 4 lesion had benign pathology. BI-RADS classification may overstate the risk of malignancy or need for biopsy in this population. Further validation of BI-RADS classification with large scale studies is needed in pediatric and adolescent patients.

Original languageEnglish (US)
Pages (from-to)1746-1750
Number of pages5
JournalJournal of pediatric surgery
Issue number10
StatePublished - Oct 2015


  • Breast mass
  • Breast ultrasound
  • Fibroadenoma
  • Pediatric radiology

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health


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