Breast masses in teenagers almost always Benign fibroadenomas. (Most Regress on their Own).

MIAMI BEACH - The vast majority of breast masses in teenagers are fibroadenomas that don't require treatment because most will eventually regress on their own, Dr. Patricia Simmons said.

"The incidence of a breast malignancy is zero per million in adolescents, and if you do see a cancer of the breast it will be a solid tumor, rarely a carcinoma, she said at the annual meeting of the North American Society for Pediatric and Adolescent Gynecology.

Dr. Simmons added that fewer than 20 cases of carcinoma in children and adolescents have been reported worldwide. In light of this fact, she recommended that physicians conduct most of their investigation of a teenage breast mass simply by doing a physical exam and taking a thorough history, because most tests are not necessary.

"You want to know if this patient has had cancer before, because this is the No. 1 risk factor for breast cancer. Has she had chest radiation, which also increases her risk, and is there breast cancer in her family?" said Dr. Simmons of the Mayo Medical School in Rochester, Minn.

If the answer to all these questions is no, a conservative approach is appropriate.

On physical exam the physician should check that the mass is mobile, because a fixed mass is very concerning, she said. Most fibroadenomas tend to occur in the upper, outer quadrant of the breast. Skin changes such as tethering, dimpling, or prominent veins are troubling signs. Nipple discharge, especially if it's bloody could be a sign of malignancy.

"Bear in mind that the general health of someone with a malignant tumor is likely to be affected, so ask about sweats, fevers, weight loss," said Dr. Simmons, ...