Breast masses in children and adolescents
- Chantay Banikarim, MD, MPH
Chantay Banikarim, MD, MPH
- Director of Adolescent Medicine
- St. Joseph's Hospital & Medical Center, Phoenix
- Nirupama K De Silva, MD
Nirupama K De Silva, MD
- Clinical Associate Professor
- University of Oklahoma-Tulsa
- Section Editors
- Jan E Drutz, MD
Jan E Drutz, MD
- Section Editor — General Pediatrics
- Professor of Pediatrics
- Baylor College of Medicine
- Amy B Middleman, MD, MPH, MS Ed
Amy B Middleman, MD, MPH, MS Ed
- Section Editor — Adolescent Medicine
- Professor of Pediatrics, Chief of Adolescent Medicine
- University of Oklahoma Health Sciences Center
The overwhelming majority of breast masses in children and adolescents are benign and self-limited. Nonetheless, the finding of a breast mass can be disconcerting to the patient and her family [1,2].
The common causes of breast masses in children and adolescents and the approach to the evaluation of an adolescent with a breast mass will be discussed below. An overview of other breast disorders and breast infections in children and adolescents, and the evaluation of breast lumps in adult women, are presented separately. (See "Breast disorders in children and adolescents" and "Clinical manifestations and diagnosis of a palpable breast mass" and "Mastitis and breast abscess in children and adolescents".)
Assessment of breast masses in young females can be challenging due to normal glandular variance. Initial steps in evaluation of breast masses are obtaining a detailed history and physical examination . The breast examination in children and adolescents and self-breast examination in adolescents are discussed separately. (See "Breast disorders in children and adolescents", section on 'Breast examination'.)
CAUSES OF BREAST ENLARGEMENT IN CHILDREN
Neonates and infants — Breast hypertrophy related to stimulation from maternal hormones can occur in both male and female neonates during the first few weeks of life (picture 1); it is sometimes associated with a thin milky nipple discharge ("witch's milk") . Neonatal breast hypertrophy usually resolves spontaneously within two weeks in boys and several months in girls. However, it may persist if the breast tissue is stimulated (eg, by attempting to express the milky discharge).
Mastitis and/or breast abscess is another cause of breast enlargement in neonates. It is discussed separately. (See "Mastitis and breast abscess in infants younger than two months", section on 'Introduction'.)
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- BREAST EXAMINATION
- CAUSES OF BREAST ENLARGEMENT IN CHILDREN
- Neonates and infants
- Prepubertal and pubertal children
- BREAST ENLARGEMENT IN ADOLESCENT MALES
- CAUSES OF BREAST MASS IN FEMALE ADOLESCENTS
- Fibrocystic change
- Juvenile fibroadenoma
- - Giant fibroadenoma
- Phyllodes tumor
- Intraductal papilloma
- Mammary duct ectasia
- Montgomery tubercles
- Breast trauma
- Breast infection
- Primary breast cancer
- - Risk factors
- Metastatic cancer
- Secondary cancer
- APPROACH TO BREAST MASS IN THE FEMALE ADOLESCENT PATIENT
- Subsequent management