Illness & Symptoms
Breast Symptoms-Teen
Is this your child's symptom?
- Breast symptoms in an older girl or teen
- Breast development (and puberty) has begun or is completed
- If NOT, try one of these:
- Breast Symptoms-Child
- Rash or Redness - Localized
- Skin Injury
Symptoms included in this guide are:
- Breast pain (most common complaint)
- Breast lump
- Breast size, shape or symmetry questions
- Redness of breast
- Nipple discharge
Causes of Breast Symptoms
- Breast lump: fibroadenoma, cyst. See Breast Lump details below
- Nipple discharge: milk, blood, pus, clear fluid
- Acute breast pain with redness (only on 1 side): often an infection.
- Acute breast pain and fullness without redness (same on both sides): always consider pregnancy
- Recurrent breast pain with menstrual periods: cyclic mastalgia. See details below.
- Chronic breast pain, unrelated to menstrual period and usually just one side: fibroadenoma, cyst. Marijuana use can cause breast pain.
Premenstrual Breast Pain and Swelling
- Main Symptom: breast fullness and pain.
- Cause: extra body fluid from female hormone cycles.
- Other symptoms: headache, swollen feet (edema).
- Timing: mainly noticed in the week prior to menstrual periods.
- Course: improves during menstrual period and goes away between menstrual periods.
- Physical Findings: fullness that can be felt throughout both breasts.
- Onset: usually 2 years after onset of periods (with onset of ovulation). Similar onset as for menstrual cramps.
- Frequency: 10% of teens and 50% of adult women.
- Treatment: mainly ibuprofen and support bra. If breast pain can't be controlled with ibuprofen, 80% can be improved by birth control pills.
- Other treatments: daily exercise and getting enough sleep.
Breast Lumps in Adolescents: Causes
- Breast masses in teens are almost always benign (not cancer).
- Breast cancer is very rare in teens (2 cases per million in young women)
- Fibroadenoma: most breast masses in teens are fibroadenomas. They are 1 inch (2.5 cm) oval or round, rubbery, non-tender mass. Most often in upper-outer quadrant of breast. Not associated with breast cancer. Natural course: 50% go away within 5 years, others need removal.
- Juvenile fibroadenomas: breast masses that are larger than 2 inches (5 cm) in size. Benign, but need to be removed by surgery.
- Breast cysts
- Breast abscess: this is a red, painful lump. Main cause is Staph bacteria. Main triggers are nipple injury, nipple piercing or lactation (producing breast milk). Needs oral antibiotics and needle removal of the pus.
- Breast collections of blood (hematomas) from injury: may take weeks or months to resolve.
When to Call for Breast Symptoms-Teen
Call Doctor or Seek Care Now
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Contact Doctor Within 24 Hours
Contact Doctor During Office Hours
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Self Care at Home
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Call Doctor or Seek Care Now
- Breast is painful to touch
- Red area or red lump with fever
- Nipple discharge that is pus (thick green or yellow) or bloody
- Your teen looks or acts very sick
- You think your teen needs to be seen, and the problem is urgent
Contact Doctor Within 24 Hours
- Red area or red lump without fever
- You think your teen needs to be seen, but the problem is not urgent
Contact Doctor During Office Hours
- Other breast lumps
- Could be pregnant (breast fullness/tenderness and missed menstrual period)
- Change in shape or appearance of breast
- Nipple discharge that is clear or milky
- Breast pain and cause is unknown. Exception: continue if only occurs before menstrual periods or with vigorous exercise.
- Age 13 or older with no breast buds or breast tissue
- You have other questions or concerns
Self Care at Home
- Breast pain in both breasts occurs monthly before menstrual periods
- Breast pain after exercise
- Breasts are not the same size, questions about (normal breast asymmetry)
Care Advice for Breast Symptoms - Teen
Breast Pain or Tenderness Before Menstrual Periods
What You Should Know:
- Some teens (10%) have breast pain and fullness on a monthly basis. This occurs just before their menstrual period.
- The discomfort can range from mild to moderate.
- Pain and swelling goes away between menstrual periods.
- Cause: normal changes caused by hormone cycles.
- Medical name: cyclic mastalgia.
Pain Medicine:
- Ibuprofen is best for this type of pain. Give ibuprofen every 6 hours, as needed.
- If you don't have ibuprofen, give acetaminophen every 4 hours. Do this until you can get ibuprofen.
Wear a Support Bra:
- Wear a well-fitted support bra or sports bra when breast pain occurs.
- This is especially important when you exercise.
- Some women with large breasts are more comfortable wearing a bra even when sleeping.
Reduce Caffeine:
- Some women report increased breast pain after drinking coffee or colas.
- If that applies to you, avoid caffeine or reduce your intake.
Expected Course:
- Should go away between menstrual periods.
- If symptoms are not better between periods, make an appointment to see your doctor.
Breast Self-Examination (BSE):
- The American College of Obstetricians and Gynecologists (ACOG) does not recommend teaching teens BSE until age 18 years.
- Reason: incidence of breast cancer between age 15 and 19 years is low (2 cases per million girls).
- BSE is best learned in person from a health care provider. If you are over 18, make an appointment to discuss this with your provider.
- Best time for BSE is at the end of each menstrual cycle. Lumps are easiest to feel at that time.
Call Your Doctor If:
- Breast pain doesn't go away between periods
- You miss a period or pregnancy test is positive
- You feel a lump
- You think your teen needs to be seen
- Your teen becomes worse
Breast Pain During or After Exercise
What You Should Know:
- Breast pain during or following hard exercise is common.
- Cause: stretching of ligaments inside the breast.
- Most common in girls with large breasts.
- Large breasts may also cause back pain.
- The pain most often lasts 1 or 2 days.
Wear a Sports Bra:
- Wear a good quality sports bra when you exercise.
Pain Medicine:
- Ibuprofen is best for this type of pain. Give ibuprofen every 6 hours, as needed.
- If you don't have ibuprofen, give acetaminophen every 4 hours. Do this until you can get ibuprofen.
Call Your Doctor If:
- You feel a lump
- Breast pain lasts more than 2 days
- You think your teen needs to be seen
- Breast pain becomes worse
Breast Size Unequal
What You Should Know:
- A difference in breast size is common and normal.
- At puberty, breast development most often starts on one side before the other.
- While breasts are growing, 50% of girls have breasts that are different sizes.
- After the breasts are mature, 25% of women still have unequal breasts. Usually the left is larger.
- The difference is most often minor.
- Medical name: normal breast asymmetry.
Treatment for Breast Asymmetry:
- Wearing a bra pad on the smaller side is an option.
- After age 18, if the difference is major, referral to a plastic surgeon can be considered.
Call Your Doctor If:
- You think your teen needs to be seen
- You have other questions or concerns
Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2025 Schmitt Pediatric Guidelines LLC.
Reviewed: 5/6/2025 Updated: 1/25/2025
