Differential Diagnosis for an 8-year-old Girl with a Breast Mass
- Single most likely diagnosis
- Breast bud (thelarche): This is the most common cause of breast masses in prepubertal girls, typically presenting as a firm, tender mass behind the nipple. The patient's age and the description of the mass are consistent with this diagnosis.
- Other Likely diagnoses
- Cyst: Breast cysts can occur in young girls and may present as tender, firm masses.
- Fibroadenoma: Although less common in prepubertal girls, fibroadenomas can occur and present as firm, mobile masses.
- Infection or abscess: Although there is no overlying erythema, a localized infection or abscess could still be considered, especially if the mass is tender.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Breast cancer: Although extremely rare in children, breast cancer must be considered to avoid delayed diagnosis.
- Sarcoma (e.g., phyllodes tumor): These rare tumors can present as breast masses and require prompt diagnosis and treatment.
- Granulomatous disease (e.g., tuberculosis): In rare cases, granulomatous diseases can manifest as breast masses.
- Rare diagnoses
- Hemangioma: A benign vascular tumor that can present as a breast mass, although rare in this location.
- Neurofibroma: A rare tumor that can occur in the breast tissue, often associated with neurofibromatosis type 1.
- Teratoma: A rare, benign tumor that can contain multiple tissue types and present as a breast mass.