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Breast Disorders

  • Overview

    The female breast changes with puberty and during the monthly menstrual cycle — some changes in the breast may require medical attention, such as breast pain and masses or lumps.

    • Breast pain can have many causes:
      • Normal swelling of breast tissue during the menstrual cycle, caused by hormonal changes
      • Infection — may be accompanied by redness and warmth, or a discharge from the nipple
      • Injury
      • Cysts
    • Breast discharge may be caused by an infection, medications, or a hormone imbalance.

    Center for Young Women’s Health

    If you want some more information about common breast conditions, check out our Center for Young Women’s Health. Children’s Hospital Boston has created a site that’s just for young women. You can find health guides written just for you, as well as quizzes, our blog and even a cookbook full of fun, tasty and nutritious recipes.

    In-Depth

    While most breast conditions are benign (non-cancerous), it is important for young women to be aware of the need for breast self-examination and proper breast health, so that she may detect any problems.

    Here are some breast conditions that young women may experience:

    Cyclical breast pain

    The most common type of breast pain is associated with the menstrual cycle. It’s nearly always hormonal. Some women begin to have pain around the time of ovulation, which continues until the beginning of their menstrual cycle.

    • The pain can either be barely noticeable or so severe that the woman cannot wear tight-fitting clothing or tolerate close contact of any kind.

    The pain may be felt in only one breast or may be felt as a radiating sensation in the under-arm region.

    Diagnosing cyclical breast pain

    It may be helpful for you to chart your breast pain to determine if the pain is cyclical or not. After a few months, the relationship between the menstrual cycle and breast pain will emerge.

    Cysts

    A cyst is a fluid-filled sac that develops in the breast tissue. They typically occur in women between the ages of 35 and 50, but are sometimes seen in adolescents. Cysts often enlarge and become tender and painful just before the menstrual period and may seem to appear overnight.

    • Cysts are rarely malignant and may be caused by a blockage of breast glands.

    Cysts can feel either soft or hard. When close to the surface of the breast, cysts can feel like a large blister, smooth on the outside, but fluid-filled on the inside. However, when they are deeply embedded in breast tissue, a cyst will feel like a hard lump because it is covered with tissue.

    Diagnosing a cyst

    Your doctor may identify a lump as a cyst by physical examination, but may then confirm the diagnosis by mammography or ultrasound examination.

    Your doctor may then perform a fine-needle aspiration as the next step in diagnosing the cyst. This procedure involves guiding a very fine needle into the cyst and drawing fluid from it.

    • This procedure is also the treatment for this condition, because once the cyst is aspirated, it collapses and disappears.

    Cysts can sometimes reappear at a later date, in which case they are simply drained again.

    Fibroadenomas

    Fibroadenomas are solid, smooth, firm, benign lumps that are most commonly found in women in their late teens and early twenties. They are the most common benign lumps that occur in women and can occur in women of any age.

    • Fibroadenomas occur twice as often in African-American women as in other American women.

    The painless lump feels rubbery, moves around freely, and very often is found by the woman herself. They vary in size and can grow anywhere in the breast tissue.

    Diagnosing a fibroadenoma

    While most physicians can recognize this type of lump simply by feeling it, your doctor will probably confirm the diagnosis by mammography or ultrasound and fine-needle aspiration. Sometimes, in very young women, the fibroadenoma is not removed.

    • However, since these tumors often enlarge with pregnancy and breastfeeding, your doctor may recommend surgically removing the fibroadenoma.

    Fat necrosis

    Fat necrosis is a condition in which painless, round, firm lumps caused by damaged and disintegrating fatty tissues form in the breast tissue.

    • Fat necrosis often occurs in women with very large breasts or in response to a bruise or blow to the breast.

    This condition may also be the result of a lumpectomy and radiation from a previous cancerous lump. In some cases, your doctor will watch the lump through several menstrual cycles, and may perform a mammogram before deciding whether or not to remove it.

    • These lumps are not malignant and there is no reason to believe that they increase your risk of cancer.

    Sclerosing adenosis

    Sclerosing adenosis is a breast condition that involves excessive growth of tissues in the breast's lobules, often resulting in breast pain.

    While these changes in the breast tissue are microscopic, they may show up on mammograms as calcifications and can produce lumps.

    • Because fat necrosis can be mistaken for cancer, the lumps are usually removed through surgical biopsy.

    Generalized breast lumpiness

    This is known under many different names, such as "fibrocystic disease" and "fibroid breasts."

    • Many doctors now believe that lumpiness is just part of the breast changes that many women undergo throughout the various stages of their lives.

    However, lumpiness in the breasts may make actual lumps harder to distinguish. So, if you have lumpy breasts, it’s important to perform regular breast self-examinations and have regular physical check-ups, including mammography.

    Breast tenderness

    Mild breast tenderness often occurs premenstrually in association with fibrocystic changes or exercise.

    • It can also be an early sign of pregnancy.

    Most adolescents don’t have severe breast tenderness, so if you do, be sure to contact your doctor.

    Breasts of different sizes

    Asymmetry of the breasts is common, especially in the early stages of breast development.

    • It’s still important to have your doctor make a careful examination should be made to rule out a breast mass, cyst or abscess.

    Hard lump

    Breast cancer is extraordinarily rare in adolescents. However, if you find a lump with any of the following qualities, make an appointment to see your doctor for a an exam:

    • Hard
    • Not movable
    • Feels like it’s attached to the chest wall
    • Combined with dimpling or puckering of the breast

    These kinds of lumps can occur with or without pain.

    Children's Hospital Boston
    300 Longwood Avenue
    Boston MA 02115

     617-355-4621
     fax: 617-738-1657
  • In depth text

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