Abordaje diagnósticoquirúrgico de tumores de mama benignos en el adolescente.

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Bibliographic Details
Title:	Abordaje diagnósticoquirúrgico de tumores de mama benignos en el adolescente.
Alternate Title:	Diagnostic and Surgical Management of Benign Breast Tumors in Adolescents.
Authors:	Vega, Guadalupe Salazar¹ lupita.219.tc@gmail.com, Adame Caballero, José Emmanuel²
Source:	Revista de la Facultad de Medicina de la UNAM. ene/feb2026, Vol. 69 Issue 1, p22-29. 8p.
Subjects:	FIBROADENOMAS, BREAST surgery, AESTHETIC judgment, TEENAGERS, OPERATIVE surgery, BREAST tumors, BENIGN tumors
Abstract (English):	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. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	El tumor benigno mamario es la patología mamaria más frecuente en el adolescente; la mayoría corresponde al fibroadenoma simple de mama. No existe consenso respecto a su tratamiento quirúrgico; sin embargo, el abordaje quirúrgico basado en la escisión simple de la lesión es la técnica más utilizada, sin considerar los resultados estéticos que esta pueda ocasionar. Caso clínico: Paciente del sexo femenino de 12 años, acompañada de su tutor (madre), sin antecedentes de importancia clínica, quien fue referida a la clínica de mama por tumor de mama izquierda asociado a mastalgia. A la exploración física se observaron mamas asimétricas a expensas de lesión en mama izquierda, la cual abarcaba en su totalidad ambos cuadrantes superiores de la mama, de aproximadamente 8 × 7 cm, dolorosa a la movilización. Cadena ganglionar sinalteraciones. Se realizó ultrasonido institucional con evidencia de tumor de mama izquierda en cuadrantes superior externo e interno, de márgenes lobulados, heterogéneo predominantemente hipoecogénico, con sombra acústica posterior, vascularidad central y periférica al Doppler, de 66 × 52 × 62 mm, en relación con probable fibroadenoma, BI-RADS 3. Se realizó biopsia trucut de la lesión en consultorio; se envió muestra a patología y, una semana después, se recabó el resultado: neoplasia fibroepitelial compatible con fibroadenoma juvenil. Hiperplasia ductal usual. Negativo para malignidad en el material examinado. Se programó para cirugía; se realizó exéresis de la lesión mediante mamoplastia de rama horizontal y se extrajo tumor multilobulado de aproximadamente 6 × 5 cm. El reporte de patología definitivo confirmó el diagnóstico de fibroadenoma juvenil. En la revisión a los 10 días de la cirugía se observó simetría de ambas mamas, con buena cicatrización de la incisión y excelente resultado estético. El fibroadenoma juvenil presenta una media de aparición a los 15 años; su etiología se asocia a una respuesta excesiva a los estrógenos; sin embargo, puede aparecer en mujeres sin menarca previa. Se diferencia principalmente del fibroadenoma convencional por su crecimiento rápido e histológicamente por el aumento de la celularidad estromal, y su principal diagnóstico diferencial es el tumor phyllodes. El tratamiento de elección es la resección simple; aunque noexiste un tratamiento estandarizado, actualmente se describen técnicas quirúrgicas que buscan preservar la anatomía independientemente del tamaño de la lesión, las cuales se prefieren por su menor tasa de complicaciones y mejores resultados estéticos, situación que impacta de manera significativa en el adolescente. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
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. [ABSTRACT FROM AUTHOR]
ISSN:	00261742
DOI:	10.22201/fm.24484865e.2026.69.1.03