The primary breast malignancy is quite uncommon in the pediatric population. Only 0.1% of primary breast malignancies occur in children and adolescents (< 1% of pediatric malignancies) 1. Fibroadenoma (benign fibroepithelial tumor) is the commonest breast mass in the pediatric population and in this age group, the commonest differential diagnosis of fibroadenoma is the phyllodes tumor, which is usually a benign tumor but can occasionally be malignant 1. Pre-operative discrimination between fibroadenoma and phyllodes tumor is strenuous due to the considerable similarities in their clinical, radiological, and pathological features 1. Fibroadenoma is a BI-RADS category 3 lesion. In the pediatric population, the treatment of the solid breast masses depends upon their size. For example, the breast mass with classical imaging features of a fibroadenoma and measuring less than 5 cm in size at initial presentation can be followed up sonographically and the biopsy is recommended for the lesions showing interval growth of ≥50% during follow-up or the lesions measuring more than 5 cm at the initial presentation 1.