It’s normal for your breasts to change as you enter your teenage years. Increases and decreases in female hormones, like estrogen and progesterone, may make your breasts tender. They 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? It’s not likely. According to research published in Contemporary Pediatrics, it’s almost unheard of for girls ages 14 and younger to develop breast cancer. The chances increase slightly as girls move through their teenage years, with just 1 teen in 1 million developing breast cancer.
Types of breast lumps
Most breast lumps in teenage girls are fibroadenomas. An overgrowth of connective tissue in the breast causes fibroadenomas, which are noncancerous. The lump is usually hard and rubbery, and you can move it around with your fingers. Fibroadenomas account for 91 percent of all solid breast masses in girls younger than 19 years of age.
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.
Symptoms of breast cancer in teens
Breast cancer tumors can feel different from the other normal lumps you might feel in your breasts. Here are some things that might indicate a lump is cancerous:
- It feels hard.
- It seems fixed to the chest wall and doesn’t move around.
- It ranges in size from about the size of a pea to the width of an adult finger.
- It might be painful.
Unlike in adult women with breast cancer, nipple discharge and having the nipple invert inward are not very common symptoms of breast cancer in teens.
Causes of breast cancer in teens
Doctors aren’t entirely sure what causes teenage breast cancer because there are so few cases. In general, though, it’s thought that childhood cancers develop because of changes in cells and DNA that occur early in life. These changes can even happen while you’re still in the womb. The American Cancer Society also notes that childhood cancers are not strongly associated with environmental and lifestyle factors like smoking or eating an unhealthy diet. But if you introduce these unhealthy behaviors early in life they can raise your risk of breast cancer when you’re older.
Risk factors for breast cancer in teens
Research on teenage breast cancer is limited. But the major risk factors appear to include a family history of the disease and having an abnormality of the breast, like a certain kind of fibroadenoma.
Radiation exposure to treat diseases like leukemia and non-Hodgkin's lymphoma during prime breast development years is known to increase breast cancer risk. It generally takes an average of 20 years to develop, when a woman is well into adulthood.
Diagnosing breast cancer in teens
If you feel anything unusual in your breast, see your doctor. After a breast exam, your doctor will ask about:
- your family’s medical history
- when you discovered the lump
- if there’s nipple discharge
- if the lump hurts
If anything looks or feels suspicious, your doctor will have you undergo an ultrasound. This test uses sound waves to see into your breasts. It can help determine whether a lump is solid, which is an indication of cancer. If it is fluid-filled, that will most likely indicate a cyst. Your doctor may also insert a fine needle into the lump to draw out tissue and test it for cancer.
Should teenagers have mammograms?
- Teenage breasts tend to be dense, making it hard for mammograms to detect lumps.
- A mammogram exposes breasts to radiation, which can lead to cell damage, especially in young, developing breasts.
Treatment of breast cancer in teens
The majority of breast cancer found in teens is secretory carcinoma. This is generally a slow growing, nonaggressive cancer. It doesn’t tend to spread to other parts of the body. Doctors treat it by surgically cutting out the cancer while sparing as much breast tissue as possible.
Doctors consider chemotherapy and radiation on a case-by-case basis. The risks these treatments pose to young, developing bodies may outweigh the benefits. Depending on the type of therapy and how long it lasts, it can affect your fertility and increase your chances of other cancers. You can still breastfeed after breast or nipple surgery. But some women may produce less milk than others.
Outlook for teens with breast cancer
According to data published in the Seminars in Oncology, researchers estimate that 80 percent of girls diagnosed with breast cancer between ages 15-19 will be alive five years later. Because breast cancer is so rare in teens, doctors and teenage girls may adopt a wait and watch approach, and delay treatment. That may account for the lower survival rate for teens with breast cancer compared with adult women with the condition.
Breast cancer is extremely rare in teens, but you should still check abnormalities. It’s also important to take steps now to prevent breast cancer later. These include:
- Eat a high-fiber diet that includes plenty of fruit.
- Exercise regularly.
- Maintain a healthy weight.
- Don’t smoke, and avoid secondhand smoke.
How to do a breast self-exam
Knowing how your breasts normally feel can help you identify any changes early on. When doing a breast self-exam, look for the following:
- breast thickness
- breast abnormalities
Here are a few ways to perform a breast self-exam:
- Undress from the waist up. Keep arms at your sides and look at your breasts in the mirror. Note any physical changes such as skin dimpling, sores, nipple discharge, or changes in breast shape and size you haven’t noticed before. Do the same with your hands on your hips and your arms folded behind your head. Be sure to look at your breasts sideways, too.
- In the shower, soap up your hands and wet your breasts. Using the finger pads of your three middle fingers feel around the breast for lumps and thickness. Move your fingers in an up and down motion with a little pressure, and cover the entire breast. Also check your armpits and chest area.
- Lie down and place a pillow under your right shoulder. Keep your right arm behind your head. Move the finger pads of your left hand around the breast in a circular, clockwise motion. Move around the entire breast and armpit. Place the pillow under your left shoulder and repeat on your left side, using your right hand.
Once you’ve established a baseline for how your breasts look and feel, it’ll be easier to identify any changes in the future. If you do notice any changes, or if anything causes you worry, let your doctor know. They can also do an exam to determine if there’s cause for concern.
Q&A: Birth control and breast cancer
Do birth control pills increase or decrease risk for breast cancer in teens?
Research studies into breast cancer risk in teens overall is limited, including studies that focus on how birth control use affects breast cancer risk. However, there have been observational studies that indicate that oral contraceptive use does not actually increase breast cancer risk due to the fact that it doesn’t have any negative impact on long-term fertility.Christina Chun, MPHAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.