{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T16:58:44Z","timestamp":1790441924610,"version":"4.1.0"},"reference-count":4,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"<jats:p>\n                    Adult-derived BI-RADS malignancy estimates may overestimate malignancy risk in pediatric breast lesions and contribute to unnecessary procedures. Pediatric breast cancer is exceedingly rare, yet BI-RADS malignancy estimates, developed for adults, are frequently applied to pediatric patients despite lacking validation. We retrospectively reviewed patients &lt;20 years old who underwent breast lesion excision at a single institution from 2018 to 2025 (\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    = 279); 217 had preoperative BI-RADS scores. Fibroadenomas accounted for 87% of lesions (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 263), and no malignancies were identified. Among patients with multiple lesions (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 44), 97.7% had at least one fibroadenoma. Despite overwhelmingly benign pathology, 55% of patients were assigned BI-RADS 4 and 15.4% BI-RADS 3. The discordance between adult-derived BI-RADS malignancy estimates and observed pathology suggests these estimates overpredict malignancy risk in pediatric patients and may contribute to avoidable surgical excision and anxiety. These findings support development of pediatric-specific risk stratification tools.\n                  <\/jats:p>","DOI":"10.1177\/00031348261492193","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T16:13:12Z","timestamp":1790093592000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Adult BI-RADS Malignancy Estimates Overpredict Cancer Risk in Pediatric Breast Lesions"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7588-7147","authenticated-orcid":false,"given":"Claudia","family":"Morales","sequence":"first","affiliation":[{"name":"Florida International University Herbert Wertheim College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8969-4150","authenticated-orcid":false,"given":"Brittany M.","family":"Rizo","sequence":"additional","affiliation":[{"name":"Florida International University Herbert Wertheim College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4142-6488","authenticated-orcid":false,"given":"Monique","family":"Motta","sequence":"additional","affiliation":[{"name":"Memorial Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4757-4450","authenticated-orcid":false,"given":"Danielle","family":"Katz","sequence":"additional","affiliation":[{"name":"Memorial Regional Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3835-1432","authenticated-orcid":false,"given":"Xiaoqi","family":"Sun","sequence":"additional","affiliation":[{"name":"Memorial Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamar","family":"Levene","sequence":"additional","affiliation":[{"name":"Joe DiMaggio Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0031-3955(05)70140-1"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2024.161916"},{"key":"e_1_3_3_4_2","first-page":"343","article-title":"The utility of BIRADS classification system in evaluating breast masses in the pediatric and adolescent populations","volume":"12","author":"Korakavi N","year":"2014","unstructured":"Korakavi N, Smith L, Rizk M, et al. The utility of BIRADS classification system in evaluating breast masses in the pediatric and adolescent populations. Springer Nature. 2014;12:343-349.","journal-title":"Springer Nature"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2020.12.025"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261492193","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348261492193","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261492193","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T16:17:01Z","timestamp":1790439421000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348261492193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":4,"alternative-id":["10.1177\/00031348261492193"],"URL":"https:\/\/doi.org\/10.1177\/00031348261492193","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]},"article-number":"00031348261492193"}}