| Cause | Clinical findings |
| Fibrocystic change | - Common in adolescents
- Breast tissue is painful before menses and improves with menstruation
- Fibrotic tissue in upper outer breast quadrants
- May have serosanguineous discharge
|
| Fibroadenoma | - Common in adolescents
- Usually asymptomatic, may be associated with breast pain before menses
- Rubbery, well-circumscribed mobile mass
- Average 2 to 3 cm (range 1 to 10 cm), may increase in size with pregnancy
- Usually occur in upper outer breast quadrants
- Recurrent or multiple in 10 to 25% of cases
|
| Giant fibroadenoma | - Grows rapidly to >5 cm
- May compress or replace normal breast tissue
|
| Phyllodes tumor | - Rare in adolescents
- Solid rather than cystic
- Average 7 cm
- May have bloody nipple discharge
|
| Mammary duct ectasia | - Subareolar mass (may be asymptomatic)
- May appear as blue mass under nipple
- May have multicolored, sticky nipple discharge
- May predispose to mastitis or breast abscess
|
| Cysts of Montgomery | - Subareolar location
- May have clear to brownish nipple discharge
- May be associated with mastitis
|
| Breast trauma | - May cause fat necrosis (solid mass)
|
| Breast infection (mastitis, breast abscess) | - Swelling
- Erythema
- Warmth
- Tenderness
- Induration of the central or peripheral breast
- Fluctuance (breast abscess)
- May be associated with purulent nipple discharge
|
| Breast cancer (primary [rare in adolescents], metastatic, or secondary) | - Hard, irregular mass
- Usually, but not always, fixed to underlying tissue
- Associated findings include:
- Enlarging solid breast mass
- Nipple retraction or discharge (bloody)
- Overlying skin changes (peau d'orange) and edema
- Axillary or supraclavicular lymphadenopathy
- Metastatic cancer may occur in adolescents with a history of:
- Rhabdomyosarcoma
- Hodgkin lymphoma
- Non-Hodgkin lymphoma
- Neuroblastoma
- Hepatocellular carcinoma
- Secondary cancer typically occurs after radiation therapy to the chest
|
