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Breast symptoms in pediatric populations are likely to be normal, variants of normal development, or classically benign. When evaluating pediatric patients, a thorough history and physical examination is key and may include US imaging if clinically indicated. Currently, there are no consensus guidelines from professional societies specific to the imaging evaluation, reporting, or management of the pediatric breast. Inappropriate utilization of additional imaging or biopsy recommendations can cause stress to patients and caregivers, added financial costs, and potential damage to the developing breast. As such, it is increasingly important for radiologists to have a clear understanding of the expected physical and imaging findings for developing breast tissue, developmental abnormalities, benign conditions, and rare malignancies. This review summarizes the expected normal developmental breast changes in the pediatric population as well as common anatomic variants. Both benign and rare malignant breast pathologies are reviewed with a discussion about clinical presentation and management to guide breast imaging trainees and practicing radiologists.<\/jats:p>","DOI":"10.1093\/jbi\/wbaf006","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T07:19:57Z","timestamp":1738221597000},"page":"492-506","source":"Crossref","is-referenced-by-count":2,"title":["Imaging Evaluation and Management of Breast Symptoms in the Pediatric Population"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1220-5102","authenticated-orcid":false,"given":"Abigail S","family":"Johnson","sequence":"first","affiliation":[{"name":"University of Wisconsin School of Medicine and Public Health , Madison, WI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Chapman","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Wisconsin School of Medicine and Public Health , Madison, WI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting Y","family":"Tao","sequence":"additional","affiliation":[{"name":"Mallinckrodt Institute of Radiology, Washington University School of Medicine , St. Louis, MO ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1172-1618","authenticated-orcid":false,"given":"Amy M","family":"Fowler","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Wisconsin School of Medicine and Public Health , Madison, WI ,","place":["USA"]},{"name":"University of Wisconsin Carbone Cancer Center , Madison, WI ,","place":["USA"]},{"name":"Department of Medical Physics, University of Wisconsin School of Medicine and Public Health , Madison, WI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"issue":"4","key":"2025090209180469700_CIT0001","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1016\/1054-139x(93)90174-n","article-title":"Prevalence and longitudinal study of breast masses in adolescents","volume":"14","author":"Neinstein","year":"1993","journal-title":"J Adolesc Health"},{"issue":"4","key":"2025090209180469700_CIT0002","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1093\/jbi\/wbaa112","article-title":"The American College of Radiology\/Society of Breast Imaging updated fellowship training curriculum for breast imaging","volume":"3","author":"Katzen","year":"2021","journal-title":"J Breast Imaging"},{"issue":"3","key":"2025090209180469700_CIT0003","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1111\/ped.14418","article-title":"Breast complaints in children and the effect of family history","volume":"63","author":"Koksal","year":"2021","journal-title":"Pediatr Int"},{"issue":"1","key":"2025090209180469700_CIT0004","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.jpag.2019.08.010","article-title":"Pediatric and adolescent surgical breast clinic: preliminary experience","volume":"33","author":"Cohen","year":"2020","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"2025090209180469700_CIT0005","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1016\/j.yapd.2021.05.006","article-title":"Pediatric breast masses: an overview of the subtypes, workup, imaging, and management","volume":"68","author":"Knaus","year":"2021","journal-title":"Adv Pediatr"},{"issue":"12","key":"2025090209180469700_CIT0006","doi-asserted-by":"publisher","first-page":"1465","DOI":"10.1177\/02841851241287924","article-title":"Assessment of pediatric breast ultrasound less is more: a practical imaging approach","volume":"65","author":"Giannotti","year":"2024","journal-title":"Acta Radiol"},{"issue":"9","key":"2025090209180469700_CIT0007","doi-asserted-by":"publisher","first-page":"900","DOI":"10.6004\/jnccn.2023.0046","article-title":"NCCN Guidelines\u00ae Insights: Breast Cancer Screening and Diagnosis, Version 1.2023","volume":"21","author":"Bevers","year":"2023","journal-title":"J Natl Compr Canc Netw"},{"issue":"5S","key":"2025090209180469700_CIT0008","doi-asserted-by":"publisher","first-page":"S146","DOI":"10.1016\/j.jacr.2023.02.013","article-title":"Expert Panel on Breast Imaging. 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