It is understandable to feel concerned about breast health, especially given the various changes that occur during teenage years. While breast cancer is predominantly a disease affecting older adults, it is not entirely impossible for teenagers to be diagnosed with it. Most breast lumps or changes observed in teens are benign, meaning they are not cancerous.
Is Breast Cancer Possible in Teens?
Breast cancer is exceedingly rare in teenagers. Between 2012 and 2016, the incidence rate for female breast cancer in 15- to 19-year-olds in the United States was approximately 0.1 in 100,000, which translates to about 1 teen in 1 million. The risk of developing breast cancer significantly increases with age, with only a small percentage of cases occurring in individuals under 35.
The majority of breast lumps found in adolescents are non-cancerous. Common benign breast masses in teens include fibroadenomas and cysts. Fibroadenomas are solid, smooth, firm, and typically painless lumps that can move easily within the breast tissue. They are the most common benign breast tumors in adolescents.
Cysts are fluid-filled sacs, often the most common type of lump in children and teens, and are almost always benign. Hormonal fluctuations during puberty can cause breast tenderness, thickening, and the formation of lumps and bumps that are part of normal development.
Recognizing Potential Signs
Understanding potential signs can lead to prompt medical evaluation if concerns arise. A new lump or a firm area in the breast that feels different from the surrounding tissue warrants attention. Unlike many benign lumps that might be movable, a cancerous lump can feel hard and fixed to the chest wall.
Changes in breast size or shape, or persistent pain not linked to the menstrual cycle, are signs to note. Skin changes on the breast, such as dimpling, puckering, redness, rash, or thickening, should be observed. Nipple changes, including discharge (especially if bloody or spontaneous), inversion, or scaling, are important to recognize. Enlarged lymph nodes in the underarm area or near the collarbone could be a sign.
What to Do If You Have Concerns
If a teenager or their parent identifies any unusual breast change, consulting a healthcare professional is the recommended immediate step. This includes changes like a new lump, persistent pain, skin changes, or nipple discharge. It is not advisable to self-diagnose or wait, even though most findings in teens are benign.
A doctor, such as a pediatrician or family doctor, will typically begin with a thorough physical examination of the breasts, chest wall, underarms, and neck. They will inquire about the duration of the lump, any changes in its size, nipple discharge, and family medical history. The healthcare provider can determine if further steps are needed to evaluate the change.
Understanding Diagnosis and Treatment
If a medical professional determines that further investigation is necessary, several diagnostic tools may be used. For adolescents, breast ultrasound is the preferred imaging modality because it effectively differentiates between solid and fluid-filled masses and avoids radiation exposure. Mammography is less commonly used for teens due to dense breast tissue and radiation concerns, but it might be considered in specific situations. Magnetic resonance imaging (MRI) is also not routinely used but can provide more detailed information if needed.
If imaging results are concerning or do not provide a clear diagnosis, a biopsy may be performed. This involves taking a small sample of breast tissue for laboratory testing to determine if the lump is benign or malignant. Core needle biopsy is often considered the standard for diagnosing breast lumps, providing detailed histological information. If breast cancer is confirmed, treatment plans are highly individualized and managed by a multidisciplinary team of specialists, considering the patient’s specific situation and the characteristics of the cancer. Treatment options can include surgery, and depending on the cancer type and stage, may also involve chemotherapy or radiation therapy.