What Should A Teenage Girl Do If She Finds A Lump In Her Breast
- Loyola University Health System
- If a lump is found in the breast of an adolescent girl, she often will undergo an excisional biopsy. However, breast cancer is rare in adolescents, and the vast majority of teenage breast lumps are benign. A recent study suggests that a breast ultrasound might eliminate the need for biopsy in many cases.
If a lump is found in the breast of an adolescent girl, she often will undergo an excisional biopsy.
However, breast cancer is rare in adolescents, and the vast majority of teenage breast lumps turn out to be benign masses that are related to hormones.
A recent Loyola University Health System study published in the American Journal of Roentgenology suggests that a breast ultrasound examination might eliminate the need for biopsy in many cases.
Loyola radiologists performed ultrasound examinations on 20 girls ages 13 to 19 who had lumps in their breasts, including one girl who had a lump in each breast. The ultrasound studies indicated that 15 of the 21 lumps appeared to be benign, while and six were suspicious.
Follow-up biopsies or clinical examinations found that all 21 lumps were benign. These findings suggest that if a breast ultrasound finds nothing suspicious, the patient likely does not need to have an excisional biopsy, said lead author Dr. Aruna Vade, a professor in the Department of Radiology at Loyola University Chicago Stritch School of Medicine.
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How Are Breast Lumps Treated In Children
Most breast lumps in children dont need treatment if they are not getting bigger or causing pain.
- A breast lump may only need to be monitored by a doctor to see if the lump gets larger or begins hurting.
- An ultrasound of the lump may be used to help diagnose what type of lump it is.
- The doctor may take a biopsy .
Lumps that are growing quickly may need to be surgically removed. This is done with a procedure called a lumpectomy .
Symptoms Of Breast Cancer
Breast cancer can have several symptoms, but the first noticeable symptom is usually a lump or area of thickened breast tissue.
Most breast lumps are not cancerous, but it’s always best to have them checked by a doctor.
You should also see a GP if you notice any of these symptoms:
- a change in the size or shape of one or both breasts
- discharge from either of your nipples, which may be streaked with blood
- a lump or swelling in either of your armpits
- dimpling on the skin of your breasts
- a rash on or around your nipple
- a change in the appearance of your nipple, such as becoming sunken into your breast
Breast pain is not usually a symptom of breast cancer.
Find out more about the symptoms of breast cancer.
Risk Factors For Death
Young age at diagnosis is a risk factor for death following local recurrence. Progression to metastatic disease is more likely in AYA compared to older women who present with early stage breast cancer. Among AYAs, the risk of cancer-related death is higher in patients with triple negative and hormone receptor negative, HER2 enriched breast cancer subtypes compared to those with hormone receptor positive, HER2 non-enriched disease .
Somatic mutations in exons 5 to 8 of the tumor suppressor gene TP53, which occur in approximately 30% of all malignant breast tumors, are more common in tumors of AYAs than older women, and confer increased risk of tumor-related death , particularly for patients with hormone-receptor negative disease . Germline mutations in PALB2 are associated with strong predisposition to early onset breast cancer and inferior breast cancer survival .
Co-morbid medical conditions may increase breast cancer mortality in AYAs. Among premenopausal breast cancer patients, obesity is associated with poor prognosis , and type 2 diabetes mellitus is associated with inferior DFS, increased recurrence and metastasis compared to age-matched breast cancer patients without these conditions.
Treatments For Breast Cancer In Men
The treatment for breast cancer in men depends on how far the cancer has spread.
Possible treatments include:
- surgery to remove the affected breast tissue and nipple and some of the glands in your armpit
- radiotherapy where radiation is used to kill cancer cells
- chemotherapy where cancer medicine is used to kill cancer cells
- other medicines that help stop breast cancer growing including tamoxifen and trastuzumab
Many men have surgery followed by 1 or more of the other treatments. This can help stop the cancer coming back in the future.
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Risk Factors You Can Change
Being physically active can help lower your risk of getting breast cancer.
- Not being physically active. Women who are not physically active have a higher risk of getting breast cancer.
- Being overweight or having obesity after menopause. Older women who are overweight or have obesity have a higher risk of getting breast cancer than those at a normal weight.
- Taking hormones. Some forms of hormone replacement therapy taken during menopause can raise risk for breast cancer when taken for more than five years. Certain oral contraceptives also have been found to raise breast cancer risk.
- Reproductive history. Having the first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy can raise breast cancer risk.
- Drinking alcohol. Studies show that a womans risk for breast cancer increases with the more alcohol she drinks.
Research suggests that other factors such as smoking, being exposed to chemicals that can cause cancer, and changes in other hormones due to night shift working also may increase breast cancer risk.
The Most Common Cancers In Young Adults
The types of cancers seen in young adults are not unique to this age group, but the most common types in this age range are largely different from those in children or older adults.
Some of the most common cancers in young adults are:
- Colorectal cancer
- Brain and spinal cord tumors
Even within this age group, some of these cancers become more or less common as people age. For example, lymphomas are more common before age 25, whereas breast, cervical, and colorectal cancers become more common after age 25.
Many other types of cancer can occur in young adults as well.
Benefits Of Mammographic Screening
The ACS systematic review also examined the effect of screening mammography on life expectancy. Although the review concluded that there was high-quality evidence that mammographic screening increases life expectancy by decreasing breast cancer mortality, the authors were not able to estimate the size of the increase 23.
Cancers Of The Female Genital Tract
Cervical cancer tends to occur in midlife. Most often it is found in women younger than 50. It rarely occurs in women younger than 20. Most cervical cancers can be found early, or even prevented, with screening tests. Vaccines against HPV, the virus linked to most cervical cancers, can also help prevent it. The most common symptom of cervical cancer is abnormal vaginal bleeding.
Overall, ovarian cancer is much more common in older women than in women younger than 40. But some less common types of ovarian cancers, known as germ cell tumors, are more common in teens and young women than in older women. Early ovarian cancer usually does not cause symptoms, but some women might feel full quickly when eating or they might have abnormal bloating, belly pain, or urinary symptoms. Women who have any of these symptoms lasting more than a few weeks should see their doctor.
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Can Breast Cancer In Younger Women Be Prevented
For women with a family history that is suggestive of a hereditary predisposition for breast cancer, a referral for genetic counseling may be appropriate. Identifying such genetic conditions will allow for a more personalized discussion on screening and preventive treatment options. For example, screening in BRCA mutation carriers begins at the age of 25.
Measures that all women can take to reduce breast cancer risk include:
- Achieving and maintaining ideal body weight
- Limiting alcohol consumption
- Getting regular exercise
That being said, if breast cancer does develop, early detection and prompt treatment can significantly increase a woman’s chances of survival. More than 90% of women whose breast cancer is found in an early stage will survive.
Young women should be counseled on breast awareness and to report any breast changes to their healthcare provider. These changes can include:
Is Teen Breast Cancer Common
Its normal for your breasts to change as you enter your teenage years. Increases and decreases in female hormones, such as estrogen and progesterone, may make your breasts tender.
Hormones can also cause you to feel thickening, and even some lumps and bumps, in your breasts as your period comes and goes each month.
Could those lumps and bumps be cancer? Its not likely. Its almost unheard of for girls ages 14 years and younger to develop breast cancer.
The chances increase slightly as girls move through their teenage years, but breast cancer in this age group is still very rare.
Between 2012 and 2016, the incidence rate for female breast cancer in 15- to 19-year-olds in the United States was
- It seems fixed to the chest wall and doesnt move around.
- It ranges in size from about the size of a pea to several inches in diameter.
- It might be painful.
Nipple discharge and having the nipple invert inward are possible symptoms of breast cancer in adult women. However, theyre not very common in teens with cancer.
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Types Of Breast Cancer
There are several different types of breast cancer, which develop in different parts of the breast.
Breast cancer is often divided into either:
- non-invasive breast cancer found in the ducts of the breast which has not spread into the breast tissue surrounding the ducts. Non-invasive breast cancer is usually found during a mammogram and rarely shows as a breast lump.
- invasive breast cancer where the cancer cells have spread through the lining of the ducts into the surrounding breast tissue. This is the most common type of breast cancer.
Other, less common types of breast cancer include:
- invasive lobular breast cancer
- inflammatory breast cancer
It’s possible for breast cancer to spread to other parts of the body, usually through the blood or the axillary lymph nodes. These are small lymphatic glands that filter bacteria and cells from the mammary gland.
If this happens, it’s known as secondary, or metastatic, breast cancer.
What Causes Lumps In The Breasts Of Girls
Fibroadenomas account for 91 percent of all solid breast masses in girls younger than 19 years old. Other less common breast lumps in teens include cysts, which are noncancerous fluid-filled sacs. Banging or injuring breast tissue, possibly during a fall or while playing sports, can also cause lumps.
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What Is Breast Cancer
The human body is made of tiny building blocks called cells. Your body creates them, replacing those that die with new ones. Usually, the body creates healthy, normal cells that do just what theyre supposed to do. This includes cells in the breasts, the two rounded areas on the front of the chest.
But if a cell changes into an abnormal, sometimes harmful form, it can divide quickly over and over again without dying, making many, many copies of itself. When this happens, a tumor, abnormal body cells grouped together in the form of a mass or lump, can start to form and grow.
Breast cancer is a kind of tumor that develops in the cells of a persons breast. You may think that only women can get breast cancer, but because all people have breast tissue, men can get breast cancer as well but this is very rare.
Someone with breast cancer may have cancer cells in just one part of the breast, which might be felt as a lump. The cancer can spread throughout one or both breasts. Sometimes breast cancer spreads to other parts of the body, like the bones< , the liver, or elsewhere.
How Much Should A 13 Year Old Workout
Doctors recommend that teens age 13 to 18 get at least one hour of moderate to vigorous physical activity most days of the week. 2 The minimum amount should be 30 minutes three times a week. Not all teens meet the ideal amount, but if your teen can get 30 to 60 minutes a day three or four days a weekthats a start.
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Unique Issues For Young Women With Breast Cancer
Read our blog, An Opportunity to Live.
About 4 percent of all breast cancers diagnosed in the U.S. occur in women under 40 .
A breast cancer diagnosis is shocking for young women. At a time in life most often focused on family and career, issues of treatment, recovery and survivorship suddenly take top priority.
How Can You Tell If A Lump Is Cancerous
Bumps that are cancerous are typically large, hard, painless to the touch and appear spontaneously. The mass will grow in size steadily over the weeks and months. Cancerous lumps that can be felt from the outside of your body can appear in the breast, testicle, or neck, but also in the arms and legs.
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Why Do People Get Breast Cancer
Any woman can get breast cancer, but these things can make some women more likely to get it:
- Family history: A woman whose mother, sister, aunt, or daughter has had breast cancer is more likely to get it.
- Age: As women get older, they are more at risk for breast cancer. Teens as well as women in their twenties and thirties are less likely to get breast cancer.
- Diet and lifestyle choices: Women who smoke, eat high-fat diets, drink alcohol, and dont get enough exercise may be more at risk for developing breast cancer.
Hannahs Cancer A Scary Diagnosis
Regardless of what type of tumor it was, any kind of cancer is a heavy diagnosis to handle for a child Hannahs age, noted Lillie Shockney, administrative director of the Johns Hopkins Avon Foundation Breast Center in Baltimore, Md.
This is the youngest case Ive ever heard of, Shockney said. I find for youngsters at this age its best to not be focusing on the kind of cancer it is, but that it is cancer and that surgery and other treatment are needed.
Its hard enough for adults to get their heads around breast cancer, much less a child.
While Hannahs story is ultimately a hopeful one, Shockney said that it is also highly unusual, and she added that she does not feel that it would be appropriate for parents to believe breast cancer is a major risk for their young daughters.
I dont want the outcome to be that mothers are panicked across the country wanting to have their daughters in elementary and middle and high school to get mammograms or even clinical breast exams, Shockney said. This is a highly unusual situation.
Shockney was not the only one to express reservations about how the situation should be broached to the public. While the Auslam family has been very open about Hannahs fight, the media coverage of her experience has sparked debate among breast cancer experts as to whether or not such a rare case of cancer should be given widespread coverage.
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Trends In Breast Cancer Deaths
Breast cancer is the second leading cause of cancer death in women. The chance that a woman will die from breast cancer is about 1 in 39 .
Since 2007, breast cancer death rates have been steady in women younger than 50, but have continued to decrease in older women. From 2013 to 2018, the death rate went down by 1% per year.
These decreases are believed to be the result of finding breast cancer earlier through screening and increased awareness, as well as better treatments.
Pregnancy During And After Breast Cancer
Pregnant women who receive standard chemotherapies for breast cancer during the second and third trimester have outcomes comparable to non-pregnant breast cancer patients .
The desire for future pregnancy can affect selection of treatment protocol. One multicenter study showed that 19% of young breast cancer patients refused endocrine therapy, or chose one chemotherapy regimen over another, based on the wish to bear children in the future . Pregnancy following a diagnosis of breast cancer does not impact mortality. A large meta-analysis showed a lower relative risk of death among women who bore a child after a breast cancer diagnosis . The POSITIVE study is prospectively evaluating outcomes of pregnancy following breast cancer.
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Clinical Considerations And Recommendations
How should individual breast cancer risk be assessed?
Health care providers periodically should assess breast cancer risk by reviewing the patients history. Breast cancer risk assessment is based on a combination of the various factors that can affect risk Box 1610111213. Initial assessment should elicit information about reproductive risk factors, results of prior biopsies, ionizing radiation exposure, and family history of cancer. Health care providers should identify cases of breast, ovarian, colon, prostate, pancreatic, and other types of germline mutation-associated cancer in first-degree, second-degree, and possibly third-degree relatives as well as the age of diagnosis. Women with a potentially increased risk of breast cancer based on initial history should have further risk assessment. Assessments can be conducted with one of the validated assessment tools available online, such as the Gail, BRCAPRO, Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm, International Breast Cancer Intervention Studies , or the Claus model 34.
Is screening breast self-examination recommended in women at average risk of breast cancer, and what should women do if they notice a change in one of their breasts?
Should practitioners perform routine screening clinical breast examinations in average-risk women?
When should screening mammography begin in average-risk women?
How frequently should screening mammography be performed in average-risk women?