Paediatric referrals to the one stop breast clinic: which patients benefit the most and proposal of guidelines
Association of Breast Surgery ePoster Library. Kleidi E. 05/15/17; 166248; P124
Mrs. Eleftheria Kleidi
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Abstract
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Introduction
Most Breast Units offer a One Stop Breast Clinic (OSBC) for new referrals; however this is predominantly for adult patients. Paediatric patients with breast symptoms are either referred to paediatrics or to the OSBC. There are no national guidelines about which service to refer children to.
Methods
Patients <18 years old presenting at the OSBC of a single breast unit were retrospectively identified over a 3-year period. Data were collected on patient demographics, presenting complaint, investigations, diagnosis and outcome. Data analysis was performed using the SPSS 19.0 tool.
Results
A total of 61 patients were analysed with a mean age of 15.7 years. 80% were female. 60% of females presented with a lump. All of those under 13 were discharged with no intervention. Females aged 16 and 17 years old were most likely to have an ultrasound showing pathology (36 patients; 2 cysts, 8 fibroadenomata, 1 abscess). 92% of male patients were diagnosed with gynaecomastia. All those under 16 were discharged with no intervention. The benefit of OSBC was greater for all patients 16-17 years old versus younger patients (Pearson correlation, p=0.048).
Conclusions
It is reasonable to assess older children in a OSBC, as ultrasound is available straight away and the findings are similar to those seen in young adults. Females under 13 years old and males under 16 years old benefitted less. Patients in these age groups, unless presenting with an abscess or infection, could be seen in a clinic without ultrasound facilities or seen by paediatricians.
Most Breast Units offer a One Stop Breast Clinic (OSBC) for new referrals; however this is predominantly for adult patients. Paediatric patients with breast symptoms are either referred to paediatrics or to the OSBC. There are no national guidelines about which service to refer children to.
Methods
Patients <18 years old presenting at the OSBC of a single breast unit were retrospectively identified over a 3-year period. Data were collected on patient demographics, presenting complaint, investigations, diagnosis and outcome. Data analysis was performed using the SPSS 19.0 tool.
Results
A total of 61 patients were analysed with a mean age of 15.7 years. 80% were female. 60% of females presented with a lump. All of those under 13 were discharged with no intervention. Females aged 16 and 17 years old were most likely to have an ultrasound showing pathology (36 patients; 2 cysts, 8 fibroadenomata, 1 abscess). 92% of male patients were diagnosed with gynaecomastia. All those under 16 were discharged with no intervention. The benefit of OSBC was greater for all patients 16-17 years old versus younger patients (Pearson correlation, p=0.048).
Conclusions
It is reasonable to assess older children in a OSBC, as ultrasound is available straight away and the findings are similar to those seen in young adults. Females under 13 years old and males under 16 years old benefitted less. Patients in these age groups, unless presenting with an abscess or infection, could be seen in a clinic without ultrasound facilities or seen by paediatricians.
Introduction
Most Breast Units offer a One Stop Breast Clinic (OSBC) for new referrals; however this is predominantly for adult patients. Paediatric patients with breast symptoms are either referred to paediatrics or to the OSBC. There are no national guidelines about which service to refer children to.
Methods
Patients <18 years old presenting at the OSBC of a single breast unit were retrospectively identified over a 3-year period. Data were collected on patient demographics, presenting complaint, investigations, diagnosis and outcome. Data analysis was performed using the SPSS 19.0 tool.
Results
A total of 61 patients were analysed with a mean age of 15.7 years. 80% were female. 60% of females presented with a lump. All of those under 13 were discharged with no intervention. Females aged 16 and 17 years old were most likely to have an ultrasound showing pathology (36 patients; 2 cysts, 8 fibroadenomata, 1 abscess). 92% of male patients were diagnosed with gynaecomastia. All those under 16 were discharged with no intervention. The benefit of OSBC was greater for all patients 16-17 years old versus younger patients (Pearson correlation, p=0.048).
Conclusions
It is reasonable to assess older children in a OSBC, as ultrasound is available straight away and the findings are similar to those seen in young adults. Females under 13 years old and males under 16 years old benefitted less. Patients in these age groups, unless presenting with an abscess or infection, could be seen in a clinic without ultrasound facilities or seen by paediatricians.
Most Breast Units offer a One Stop Breast Clinic (OSBC) for new referrals; however this is predominantly for adult patients. Paediatric patients with breast symptoms are either referred to paediatrics or to the OSBC. There are no national guidelines about which service to refer children to.
Methods
Patients <18 years old presenting at the OSBC of a single breast unit were retrospectively identified over a 3-year period. Data were collected on patient demographics, presenting complaint, investigations, diagnosis and outcome. Data analysis was performed using the SPSS 19.0 tool.
Results
A total of 61 patients were analysed with a mean age of 15.7 years. 80% were female. 60% of females presented with a lump. All of those under 13 were discharged with no intervention. Females aged 16 and 17 years old were most likely to have an ultrasound showing pathology (36 patients; 2 cysts, 8 fibroadenomata, 1 abscess). 92% of male patients were diagnosed with gynaecomastia. All those under 16 were discharged with no intervention. The benefit of OSBC was greater for all patients 16-17 years old versus younger patients (Pearson correlation, p=0.048).
Conclusions
It is reasonable to assess older children in a OSBC, as ultrasound is available straight away and the findings are similar to those seen in young adults. Females under 13 years old and males under 16 years old benefitted less. Patients in these age groups, unless presenting with an abscess or infection, could be seen in a clinic without ultrasound facilities or seen by paediatricians.
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