While exceedingly rare, it is possible for a 14-year-old to develop breast cancer. Most breast changes experienced by adolescents are benign and related to normal development, but understanding the true incidence and typical breast changes can provide reassurance.
The Reality of Pediatric Breast Cancer
Breast cancer is highly uncommon in teenagers. Between 2012 and 2016, the incidence rate for female breast cancer in 15- to 19-year-olds in the United States was 0.1 in 100,000, or roughly 1 teen in 1 million. The risk increases slightly as girls move through their teenage years, but remains very low.
When breast cancer does occur in adolescents, it is often a specific type, such as secretory carcinoma, also known as secretory adenocarcinoma. This type of cancer is generally slow-growing and not aggressive. While spread to other body parts is rare, it can occur to local lymph nodes. The causes are not fully understood due to the limited number of cases, but are thought to involve changes in cells and DNA that happen early in life, potentially even before birth.
Recognizing Potential Signs
Certain breast changes warrant medical evaluation. A new lump or unusual thickening in the breast or underarm area is one such sign. Changes in the breast’s skin, such as redness, dimpling, or a rash, can also be present. Swelling of all or part of the breast, a change in its size or shape, or nipple discharge (especially if clear or bloody and not breast milk) are additional signs to note.
Nipple changes, such as the nipple turning inward, or persistent breast or nipple pain that does not resolve, are other indicators that warrant attention. While these signs are typically not indicative of cancer at this age, any new or persistent breast changes should always be evaluated by a healthcare professional.
Common Non-Cancerous Breast Changes
Many breast changes experienced by adolescents are benign and part of normal development. Fibroadenomas are the most frequent type of benign breast mass in teenage girls, accounting for 91% of all solid breast masses in girls younger than 19. These are smooth, solid, firm lumps of fibrous tissue that are not cancerous and are typically harmless. They often feel rubbery and move easily under the skin, with an average size of about 1 inch (2.5 cm). Fibroadenomas may become tender or cause soreness before a menstrual period and can grow slowly, sometimes even shrinking or disappearing over time.
Breast cysts are common non-cancerous fluid-filled sacs that can enlarge and become tender or painful before a menstrual period. They may appear suddenly and feel soft or hard, though they are rarely cancerous. Normal pubertal breast development, known as thelarche, is the first physical sign of puberty. This breast budding often appears as a firm, sometimes tender lump under the nipple, but is a normal physiological process.
Breast asymmetry, where one breast is larger or develops faster, is common and usually normal during puberty. Most cases are idiopathic (cause unknown) and often become more equal over time, though some difference can persist.
When to Seek Professional Guidance
Consult a healthcare professional if an adolescent or their guardian observes any breast changes. While most changes are benign, a doctor can provide a proper evaluation and diagnosis. Assessment typically involves a physical examination, inquiring about the changes, their duration, and any associated symptoms.
Depending on findings, a healthcare provider may recommend imaging tests, such as an ultrasound, which is often preferred for evaluating breast tissue in young patients. In some cases, a biopsy might be performed. Seeking medical advice ensures appropriate management, even if the changes are determined to be harmless.