Breast Ultrasound in Childhood and Adolescence in Ibadan, Nigeria: Imaging Findings and Correlation of BI-RADS with Histopathology

Abstract

Background: Breast masses in children are relatively uncommon when compared with adults but are overwhelmingly benign. Ultrasound is the most accessible and safest means of imaging breast masses in this age group.

Objectives: To describe ultrasound findings and evaluate the relationship between Breast Imaging Reporting and Data System (BI-RADS) category and histology reports in paediatric and adolescent breast presentations.

Methods: A retrospective review of 43 paediatric and adolescent breast ultrasound cases referred to the Radiology Department at the University College Hospital, Ibadan, Nigeria, over 10 years (2006-2015) was conducted. Age, body mass index (BMI), prior breast disease, BI-RADS classification, and histopathology results were extracted from the departmental records. 

Results: The Children were aged 8–18 years (mean: 16.13 years), with 72.1% being older than 15 years. BMI was normal for most (81.4%) children. Most lesions were benign or negative on BI-RADS assessment, while 3 cases (7.0%) were categorised as highly suggestive of malignancy; all the cases were histologically confirmed. BI-RADS category showed a strong association with malignancy (χ² = 43.00, p < 0.001), with malignancy occurring only in the highest of the six categories. No significant associations were found between malignancy and age (p = 0.559) or BMI (p = 0.598), although slightly higher values of BI-RADS were observed in malignant cases.

Conclusions: Breast lesions in Nigerian children and adolescents are predominantly benign. BI-RADS demonstrated strong predictive value for malignancy in this study. Few children who require imaging for further assessment of breast masses should be promptly referred.