We report five adolescent girls with secondary breast tumours. All wer
e imaged by US and the imaging findings have been analysed. Four girls
had rhabdomyosarcoma as the primary malignant disease and one had leu
kaemia. US features were variable, but most of the cases showed hetero
geneous nodules which were quite different from the usual benign lesio
ns (fibroadenoma, abscess, cyst) encountered at this age. The metastas
es produced a variety of echo characteristics: masses with well-define
d margins, hyperechoic foci and sonolucent or hypoechoic nodules with
posterior attenuation or lacking posterior enhancement. One lesion was
round and heterogeneous with a hyperechoic centre. These US findings
in an adolescent girl suggest the need for fine-needle aspiration. Mam
mograms, when performed, never revealed microcalcifications and were q
uite difficult to analyse at this age, due to the dense glandular brea
st tissue.