Introduction: Breast masses in children and adolescents are uncommon and the vast majority are benign.Despite the low risk of malignancy a thorough workup is warranted and surgical excision may be recommended. In the current literature there are limited analyses of breast masses in the pediatric population.In addition, management of breast masses in children and adolescents is highly variable. The purpose of our study is to analyze the demographic characteristics, pathology and clinical management of 119 pediatric patients with breast masses one of the largest studies in the literature to date. Methods : We performed a retrospective review of all patients who underwent surgical excision of a breast mass at a single tertiary care center from June 2009 to November 2013. Demographic data, imaging, pathology results and management plans were reviewed. Results : Over the study period 135 masses were excised from 119 patients.117 of the patients were female, the average age of patients was 15.3 years, the average mass size was 3.15 cm and 20.3 had a family history of breast cancer. 68 of patients had a pre-operative ultrasound, and 31.9 underwent a period of observation recommended by either their primary physician or by their surgeon. The most common documented indication for resection was patient anxiety. All breast masses in this population were benign, with fibroadenoma being by far the most common histopathology. Conclusions : Breast malignancy is extremely rare in the pediatric population and recommended management in the absence of concerning clinical or radiologic findings is non-operative. However, only 31.9 of patients in our series underwent some form of observation. In addition,patient and family anxiety was documented as a reason for excision in a significant number of cases.