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Oral contraceptive (OC) use in young women has been associated with an increased risk of breast cancer. This matched case-control study aims to elucidate the combined effects of OC use and genetic factors in a population-based series of BRCA1/2 mutation-tested early-onset breast cancers. A first invasive breast cancer was diagnosed in 259 women aged 40 years between 1990 and 1995 in the South Swedish Health Care Region. A total of 245 women were included in this study. Information on family history of cancer, reproductive factors, smoking and OC use was obtained from questionnaires or patient charts. Three age-matched controls per case were chosen from a prospective South Swedish cohort. Ever OC use and current OC use were not associated with breast cancer. Cases were more likely to have used OCs before age 20 years (adjusted odds ratio (OR) 2.10 (95% CI 1.32-3.33)) and before their first child (adjusted OR 1.63 (95% CI 1.02-2.62)). When stratified by age, the effect of early OC use was limited to women diagnosed prior to age 36 years (OR 1.53 (1.17-1.99) per year of OC use prior to age 20 years). The risks were similar for low-dose and high-dose OCs. The probability of being a BRCA1/2 mutation carrier was three times higher among cases who started OC use prior to age 20 years compared with cases who started at age 20 years or older or who had never used OCs. However, the duration of OC use was similar among cases with and without BRCA1/2 mutations. No association was seen with a first-degree family history of breast cancer. Each year of OC use prior to age 20 years conferred a significantly increased risk for early-onset breast cancer, while there was no risk associated with use after age 20 years.
Children experience dramatic growth changes during their teenage years, and in many instances it's hard to know what's normal. When breast-related symptoms are interfering with your everyday life, or that of your child, this may not simply be a phase or a cosmetic issue. Some pediatric breast conditions can affect physical health and mental well-being, and may benefit from evaluation and in some cases treatment.
The Adolescent Breast Center at Boston Children's Hospital is the first program in the nation dedicated exclusively to evaluating and treating breast conditions in teens, children and young adults. Our center uses a broad, research-driven approach focused on restoring self-confidence and improving quality of life.
We've assembled a team of experts to help manage and treat the full spectrum of breast diagnoses, with an understanding of both the physical and psychological impacts these conditions have on adolescents. We work together with the Division of Adolescent Medicine and the Department of Surgery at Boston Children's to offer comprehensive evaluation, diagnosis, and treatment recommendations. These include surgical options as well as non-surgical solutions. We believe a patient's age shouldn't deter physicians from evaluating and treating serious breast-related problems.
Our center has led the way in the research of breast conditions in adolescents. Brian Labow, MD, a cofounder of the center, is the principal investigator for the Adolescent Breast Clinic Registry, which is publishing first-of-its-kind research in peer-reviewed journals examining the impact of these conditions on adolescents.
This research is starting to paint a picture of breast health as much more than a cosmetic issue. Healthy breast development is central to a young adult's emerging identity. Informing patients that these conditions are not that uncommon, and that treatment options exist, is often enough to start improving a teenager's outlook on life.
Sometimes, guys develop breasts during puberty. This is called gynecomastia (pronounced: guy-nuh-ko-MAS-tee-uh). It's usually due to normal hormone changes during puberty, and almost always goes away on its own within a few months to a couple of years.
Gynecomastia causes breast enlargement. It can happen in one or both breasts. Sometimes a small, rubbery lump can be felt under the nipple. The breast area might feel sore, especially in the months after gynecomastia begins.
Some medicines, drugs (including alcohol, marijuana, amphetamines, and heroin), anabolic steroids (taken to build muscle and improve strength), and other medicines also can cause gynecomastia. The herbal supplements tea tree oil and lavender oil may also lead to gynecomastia. Rarely, gynecomastia can be a sign of other medical conditions.
There's also something called pseudogynecomastia (or false gynecomastia). This has nothing to do with puberty or hormones. It's when some guys have extra fat in the chest area that makes it look like they have breasts. A health care provider's exam can tell whether a guy has gynecomastia or pseudogynecomastia.
Even though it's just a temporary change for most teens, some guys with gynecomastia might feel embarrassed or self-conscious about their appearance. Many guys find that wearing loose-fitting shirts helps make it less noticeable until the breasts shrink.
One of the most common plastic surgery procedures among teens is breast surgery. Adolescence is a critical period of development both physically and mentally, and self-image can play a vital role in long-term happiness and well-being. Breast surgery should only be performed on teens who are physically and mentally mature and who can maintain realistic expectations.
Before pursuing breast surgery, teen patients should have an open, honest discussion with their parents or guardians about any concerns and aesthetic goals. Our team can perform a pre-operative evaluation and discuss the expectations with your teen, in addition to creating a computerized image of what the results may look like. We believe these are essential first steps for any teenager before undergoing cosmetic plastic surgery.
We want to make sure our patients and parents are well educated on the procedure. We believe all parties should be present at all visits and be involved in all data sharing, discussions and decision-making. We work with pediatric patients every day, so we understand how they think and feel. We listen to their concerns and help set expectations.
We make every effort during the visit and examination to make patients comfortable. Magdalena Soldanska, MD, one of the only female board-certified pediatric plastic surgeons in Georgia, is also available for patients who are more comfortable with a female doctor.
We have remained at the forefront of medicine by fostering a culture of collaboration, pushing the boundaries of medical research, educating the brightest medical minds and maintaining an unwavering commitment to the diverse communities we serve.
A breast lump or is a bulge or bump in the breasts. Breast lumps are more common in older women, but they can also develop in teenagers, young girls and babies. There are many different types of breast lumps that happen in children, but most are benign (noncancerous). Even though breast lumps can be harmless, it is still important to see a doctor if you or your child notice changes in what their breasts normally feel like.
Breast lumps can look and feel different depending on the type. They can be painful or painless, and may feel hard, soft, or rubbery under the skin. Some breast lumps are moveable and some are not. They can be many different sizes. It is important for girls and young women to be familiar with the normal shape of their breasts, so they can recognize if a lump appears.
Lumps that are growing quickly may need to be surgically removed. This is done with a procedure called a lumpectomy (when a doctor removes the abnormal breast tissue while your child is asleep under general anesthesia).
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However, as the authors of a new study state in the December issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS), some plastic surgeons remain hesitant to operate on adolescents. In the study, the authors present objective data exploring the relationship among overgrowth of breast tissue, body mass index (BMI) and age at first menses (first menstrual cycle) as a guide for patients and plastic surgeons for determining the appropriate timing for breast reduction surgery.
The major concern about breast reduction surgery on adolescents is that the patient's breasts may continue to grow after surgery. This issue often leads primary care providers to delay the patient's referral to a plastic surgeon until after the patient has reached chronological adulthood.
"Additionally, many third-party payors impose age restrictions when determining coverage for reduction mammaplasty without regard for the patient's psychological and developmental maturity," Brian Labow, MD, FACS, FAAP, of Boston Children's Hospital, and coauthors write.
Of the total study sample only six percent of patients had breast regrowth after surgery, and, in about half of those cases, breast regrowth resulted in a return of musculoskeletal symptoms, such as neck and back pain. Breast regrowth was due to additional growth of the breast gland in about 52 percent of cases, as opposed to weight gain in 48 percent.
Body weight had a significant impact on maturation and breast development. Girls who were overweight or obese were younger at the time of their first menstrual period compared to healthy-weight patients. Even after controlling for BMI, patients with earlier menstrual cycles had more severe breast enlargement.
In obese patients, performing breast reduction earlier than nine years after the first menstrual period was linked to a 20 percent increase in the likelihood of glandular breast regrowth. In non-obese women, the risk of breast regrowth was relatively low, as long as surgery was performed at least three years after the first menstrual period.
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