Breast cancer, characterized by the uncontrolled growth of abnormal cells in breast tissue. Understanding breast health involves recognizing normal changes and knowing when to seek medical advice for unusual symptoms. This awareness is important for everyone, including teenagers, to ensure concerns are addressed appropriately.
The Reality: Breast Cancer in Teenagers
Breast cancer is exceptionally rare among teenagers. For females aged 15 to 19 in the United States, the incidence rate between 2012 and 2016 was approximately 0.1 in 100,000. While rare, it is possible for adolescents to develop breast cancer, though it accounts for less than 1% of all breast cancer cases.
When breast cancer does occur in this age group, it is often a specific type called secretory carcinoma. This type is generally slow-growing and less aggressive than other forms of breast cancer, though it can spread to local lymph nodes. Other types, such as invasive ductal carcinoma and triple-negative breast cancer, can also occur and may present with more aggressive characteristics.
Common Breast Lumps and Changes
Teenagers experience numerous changes in their breasts due to hormonal fluctuations, which are a normal part of development. These hormonal shifts can cause breasts to feel tender, and lead to the development of thickening or small lumps that may come and go with the menstrual cycle. Early breast development often begins with the appearance of breast buds, which are normal lumps that form under the nipple.
Most breast lumps found in teenagers are benign, meaning they are non-cancerous. Fibroadenomas are the most common type, accounting for about 91% of solid breast masses in girls younger than 19. These lumps typically feel firm, rubbery, and movable, and are usually painless. Cysts, which are fluid-filled sacs, are also common and can feel soft or hard, sometimes becoming tender before a menstrual period.
While benign conditions are far more common, it is still helpful to be aware of signs that warrant medical attention. These include:
A new or persistent lump or thickening in the breast or armpit, especially if it feels hard or fixed.
Changes to the breast skin, such as dimpling, redness, rash, or thickening.
Nipple changes like inversion, scaling, or any discharge that is not breast milk, particularly if it is bloody.
Persistent breast pain unrelated to the menstrual cycle.
Swelling of the breast.
Enlarged lymph nodes in the armpit.
When to Consult a Doctor
It is advisable to consult a healthcare professional for any new, persistent, or unusual changes in breast tissue. If a lump does not resolve, or if it grows larger or becomes harder, seeking medical advice is important. Prompt evaluation is also recommended for persistent pain, swelling, or any noticeable skin changes in the breast area.
A medical evaluation typically begins with a physical examination of the breast and a review of the individual’s personal and family medical history. Imaging tests such as an ultrasound are commonly used for teenagers due to the density of adolescent breast tissue, which can make mammograms less effective. In some cases, an MRI may be used. If imaging reveals an abnormal area, a biopsy, which involves taking a small tissue sample, may be performed to determine the nature of the lump. Most evaluations ultimately confirm a benign condition, but timely assessment is important for accurate diagnosis.
Understanding Potential Risk Factors
For teenagers, breast cancer risk factors are primarily linked to hereditary factors given the rarity of the disease in this age group. A strong family history of early-onset breast cancer, particularly in close relatives, can increase an individual’s predisposition. Inherited genetic mutations, such as those in the BRCA1 or BRCA2 genes, are recognized examples that can elevate breast cancer risk and influence a person’s lifetime risk.
Other genetic mutations, including those in TP53, PTEN, STK11, PALB2, and CDH1, are also associated with an increased risk, though they are less common. For individuals with a significant family history of breast or ovarian cancer, genetic counseling may be recommended to assess potential risks and discuss appropriate monitoring. Exposure to radiation can also be a contributing factor, though it is less common as a primary risk in this young population.