Breast Cancer Awareness Month feature
Teenage Girls with Breast Cancer
Question: I've read about girls as young as 14 being diagnosed with breast cancer, and I find that frightening. I know young women can get breast cancer, but adolescent girls?
Answer: By Dr. Susan Love
While in rare instances a teenage girl may have to have surgery to remove a lump from her breast, it is virtually unheard of for that lump to be breast cancer. The lumps that these girls have are not the type of tumor that becomes breast cancer but are either juvenile fibroadenoma or cystosarcoma phyllodes.
Fibroadenoma is the second most common form of benign breast disease; it is most common in women under 30. Juvenile fibroadenoma is a benign growth that occurs when normal breast development goes slightly awry. Fibroadenomas are hard, round, and easy to feel. And although they can be very large--as big as 8-9 cm-- they are unlikely to cause any pain.
Fibroadenomas are removed because of
their size, not because they are cancerous or because they will
become cancerous. And while it is certainly scary for a teenage
girl to have to think about having surgery on her breast, it is
important that she and those who support her understand that she
has a lump, not cancer.
Cystosarcoma phyllodes is a tumor that occurs only in the breast,
and what causes it remains unknown. It is very rare--less than
1% of all beast tumors are classified as cystosarcoma phyllodes.
Even though cystosarcoma phyllodes contains the word "sarcoma" (which would make you think of cancer) the majority of these tumors are benign. This is why doctors have begun to refer to them as phyllodes tumors.
Phyllodes tumors tend to be large--the average size is about 5 cm--and to grow very quickly. Like a fibroadenoma, these tumors do not typically cause any pain and are hard, round, and easy to feel.
Phyllodes tumors are typically removed with an excision. If the tumor recurs, which happens about 20-35% of the time, a second excision or possibly a mastectomy may be needed.
About 10% of phyllodes tumors metastasize, and when they do they typically spread to the lung, bones, heart, and liver. Unlike with a typical breast tumor, there is no systemic treatment (chemotherapy or hormonal therapy, like tamoxifen) that phyllodes tumors have been found to respond to. They do not respond to radiation either. It is important to keep in mind, though, that these tumors are rare to begin with, and even rarer in teenage girls.
Does the fact that a teenage girl could possibly develop a juvenile fibroadenoma or phyllodes tumor mean we should start educating them about these diseases?
It's never too early to begin educating teenage girls about their breasts, or helping them to feel comfortable with their breast as they develop. It is also important to let girls know that if they ever feel something odd in one of their breasts they should tell a parent or guardian or their doctor right away.
I don't believe, though, that teenage
girls should be told about these diseases in a way that makes
them worry that they might develop a juvenile fibroadenoma or
a phyllodes tumor. It's too rare. And they certainly shouldn't
be worried that they will develop breast cancer at 15.
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Susan M. Love is an author, teacher, surgeon, researcher, and activist. Having dedicated her life to eradicating breast cancer and educating patients on women's health issues, Dr. Love is one of the founders and a board member of the National Breast Cancer Coalition, and was appointed by President Clinton to the National Cancer Advisory Board. She is an Adjunct Professor of Surgery at UCLA and the Medical Director of the Santa Barbara Breast Cancer Institute, a nonprofit organization. She is the author of Dr. Susan Love's Breast Book and Dr. Susan Love's Hormone Book.
Contact Dr. Susan Love
as follows: http://www.susanlovemd.org