Infantile Hemangioma of the Breast: Long-Term Assessment of Outcomes
Background:. The literature is meager regarding the natural history and outcomes of infantile hemangiomas (IHs) in the breast. Treatment in childhood may be considered due to psychosocial and physical concerns with breast development. Early surgical intervention may cause iatrogenic breast asymmetry...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2024-01-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005506 |
| _version_ | 1797341098918543360 |
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| author | Brian I. Labow, MD, FACS, FAAP Shomoukh A. Alshamekh, MD Valerie M. Carlberg, MD Jennifer L. Zacur, MD, PhD Lily C. Uihlein, MD, JD John B. Mulliken, MD Marilyn G. Liang, MD |
| author_facet | Brian I. Labow, MD, FACS, FAAP Shomoukh A. Alshamekh, MD Valerie M. Carlberg, MD Jennifer L. Zacur, MD, PhD Lily C. Uihlein, MD, JD John B. Mulliken, MD Marilyn G. Liang, MD |
| author_sort | Brian I. Labow, MD, FACS, FAAP |
| collection | DOAJ |
| description | Background:. The literature is meager regarding the natural history and outcomes of infantile hemangiomas (IHs) in the breast. Treatment in childhood may be considered due to psychosocial and physical concerns with breast development. Early surgical intervention may cause iatrogenic breast asymmetry and possibly impair lactation later in life. This study characterizes the clinical presentation, management, and long-term outcomes of IHs arising in the breast.
Methods:. Female patients aged 11 years or older at presentation were included in a retrospective review of the Vascular Anomalies Center database for patients with IHs of the breast seen at our institution between 1980 and 2020. Breast development was ascertained by a structured telephone interview, physical examination, or photographs.
Results:. A total of 10 patients met criteria for inclusion in this study. The median age at enrollment was 14 years (11–36 years). Breast asymmetry was noted in 60% of patients (n = 6). Of the four patients who underwent subtotal excision of breast IH, three developed ipsilateral breast hypoplasia. Breast asymmetry was also noted in three of five patients who did not receive medical treatment: two with hypoplasia and one with hyperplasia. No asymmetry was noted in the single patient who received corticosteroid.
Conclusions:. IHs involving the nipple–areola complex can be associated with breast asymmetry. Hypoplasia was noted in patients not treated with corticosteroid or resection in childhood. These findings suggest that systemic treatment should be considered. Longitudinal follow-up on patients treated with propranolol will elucidate its possible benefits in minimizing breast asymmetry. |
| first_indexed | 2024-03-08T10:12:58Z |
| format | Article |
| id | doaj.art-bc50ec040b1c41be8eb7c03dd1bf850e |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-08T10:12:58Z |
| publishDate | 2024-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-bc50ec040b1c41be8eb7c03dd1bf850e2024-01-29T07:01:15ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742024-01-01121e550610.1097/GOX.0000000000005506202401000-00002Infantile Hemangioma of the Breast: Long-Term Assessment of OutcomesBrian I. Labow, MD, FACS, FAAP0Shomoukh A. Alshamekh, MD1Valerie M. Carlberg, MD2Jennifer L. Zacur, MD, PhD3Lily C. Uihlein, MD, JD4John B. Mulliken, MD5Marilyn G. Liang, MD6From the * Harvard Medical School, Boston, Mass.From the * Harvard Medical School, Boston, Mass.From the * Harvard Medical School, Boston, Mass.From the * Harvard Medical School, Boston, Mass.From the * Harvard Medical School, Boston, Mass.From the * Harvard Medical School, Boston, Mass.From the * Harvard Medical School, Boston, Mass.Background:. The literature is meager regarding the natural history and outcomes of infantile hemangiomas (IHs) in the breast. Treatment in childhood may be considered due to psychosocial and physical concerns with breast development. Early surgical intervention may cause iatrogenic breast asymmetry and possibly impair lactation later in life. This study characterizes the clinical presentation, management, and long-term outcomes of IHs arising in the breast. Methods:. Female patients aged 11 years or older at presentation were included in a retrospective review of the Vascular Anomalies Center database for patients with IHs of the breast seen at our institution between 1980 and 2020. Breast development was ascertained by a structured telephone interview, physical examination, or photographs. Results:. A total of 10 patients met criteria for inclusion in this study. The median age at enrollment was 14 years (11–36 years). Breast asymmetry was noted in 60% of patients (n = 6). Of the four patients who underwent subtotal excision of breast IH, three developed ipsilateral breast hypoplasia. Breast asymmetry was also noted in three of five patients who did not receive medical treatment: two with hypoplasia and one with hyperplasia. No asymmetry was noted in the single patient who received corticosteroid. Conclusions:. IHs involving the nipple–areola complex can be associated with breast asymmetry. Hypoplasia was noted in patients not treated with corticosteroid or resection in childhood. These findings suggest that systemic treatment should be considered. Longitudinal follow-up on patients treated with propranolol will elucidate its possible benefits in minimizing breast asymmetry.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005506 |
| spellingShingle | Brian I. Labow, MD, FACS, FAAP Shomoukh A. Alshamekh, MD Valerie M. Carlberg, MD Jennifer L. Zacur, MD, PhD Lily C. Uihlein, MD, JD John B. Mulliken, MD Marilyn G. Liang, MD Infantile Hemangioma of the Breast: Long-Term Assessment of Outcomes Plastic and Reconstructive Surgery, Global Open |
| title | Infantile Hemangioma of the Breast: Long-Term Assessment of Outcomes |
| title_full | Infantile Hemangioma of the Breast: Long-Term Assessment of Outcomes |
| title_fullStr | Infantile Hemangioma of the Breast: Long-Term Assessment of Outcomes |
| title_full_unstemmed | Infantile Hemangioma of the Breast: Long-Term Assessment of Outcomes |
| title_short | Infantile Hemangioma of the Breast: Long-Term Assessment of Outcomes |
| title_sort | infantile hemangioma of the breast long term assessment of outcomes |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005506 |
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