Breast Abnormalities (Pediatric)

What are breast abnormalities?

Your daughter may experience many breast changes in her teenage years—some are linked to the menstrual cycle, some are related to hormonal forms of birth control, and others may occur without a specific reason. Most of these changes will be benign, or non-cancerous.

Common breast changes at this age include cyclical breast pain, cysts, or fibroadenomas.

What are the symptoms of breast abnormalities?

Cyclical breast pain

This may occur during ovulation and last until the menstruation starts. Pain ranges from minor to severe, where even the pressure of clothing may cause discomfort. The pain may be local, or spread over the whole under-arm area. Cyclical breast pain often appears in only one breast; researchers are now trying to understand why one side of the body is more affected than the other.

Breast cysts

A cyst is a fluid-filled sac that often becomes larger and more painful just before the menstrual period. Sometimes it seems to appear overnight. This kind of lump may be soft or hard. It is usually benign and can be caused by a blocked breast gland.


A fibroadenoma is a solid, firm, benign lump, generally found in young women starting in their late teens and early twenties. The lump feels smooth and firm to touch, and is commonly found on self-exam. African-Americans are twice as likely to develop this type of breast lump as other patients.

Fibrocystic breast changes

Fibrocystic breasts may feel diffusely lumpy, swollen or sore, and these symptoms may worsen before the menstrual period. This kind of general breast tenderness may make it hard for a young woman to tell if she has an individual lump.

Other common symptoms of benign breast disease are related to pregnancy and breastfeeding. These include nipple discharge, breast infections and breast inflammation.

How are breast abnormalities diagnosed?

After a complete medical history and a full physical exam, our experts in adolescent gynecology may order the following tests:

  • Breast Ultrasound to further evaluate the breast tissues
  • Diagnostic Mammography, to look for masses and calcifications (the accumulation of salts in body tissue, causing it to harden)

If there is nipple discharge, other than breast milk, a sample will be sent to the laboratory for analysis. A ductogram Xray of the nipples may be required for further evaluation.

If a lump is found it may be assessed through the following biopsies. The first two procedures are typically performed by a radiologist who uses ultrasound to guide the procedure.

  • Fine needle aspiration. A very thin needle is guided into the affected are of the breast and a small tissue sample is removed then sent to the lab for analysis.
  • Core needle biopsy. A larger needle in inserted into the lump to remove a small cylinder, or core, or breast tissue. This is the send to the lab for analysis.
  • Surgical biopsy. A surgeon makes an incision in the breast and removes all or part of a lump. This is then sent to the lab for analysis.

What is the treatment for breast abnormalities?

Treatment ranges from careful monitoring to surgical removal of a lump.