Breast cancer is very rare in teens. Between 2012 and 2016, the incidence rate for female breast cancer in 15- to 19-year-olds in the United States was 0.1 in 100,000. This equals 1 teen in 1 million.

It’s normal for your breasts to change as you enter your teenage years. Increases and decreases in female hormones, such as estrogen and progesterone, may make your breasts tender.

Hormones can also cause you to feel thickening, and even some lumps and bumps, in your breasts as your period comes and goes each month.

Could those lumps and bumps be cancer? It’s not likely. It’s almost unheard of for girls ages 14 years and younger to develop breast cancer.

The chances increase slightly as girls move through their teenage years, but breast cancer in this age group is still very rare.

Between 2012 and 2016, the incidence rate for female breast cancer in 15- to 19-year-olds in the United States was 0.1 in 100,000. This equals 1 teen in 1 million. These statistics were included in a 2020 study published by the American Cancer Society (ACS).

Breast cancer tumors can feel different from the other normal lumps you might feel in your breasts. Here are some things that can indicate a lump may be cancerous:

  • It feels hard.
  • It seems fixed to the chest wall and doesn’t move around.
  • It ranges in size from about the size of a pea to several inches in diameter.
  • It might be painful.

Nipple discharge and having the nipple invert inward are possible symptoms of breast cancer in adult women. However, they’re not very common in teens with cancer.

Doctors aren’t entirely sure what causes teenage breast cancer because there are so few cases.

In general, though, it’s thought that childhood cancers develop because of changes in cells and DNA that occur early in life. These changes can even happen while you’re still in the womb.

The ACS also notes that childhood cancers aren’t strongly associated with environmental and lifestyle factors such as smoking or eating certain foods.

However, if you introduce these unhealthy behaviors early in life, they can increase your risk for breast cancer when you’re older.

Breast cancer and birth control

Some research has shown that taking hormonal birth control slightly increases the risk of breast cancer. However, once you stop using hormonal birth control, risk levels eventually return to normal.

The University of Texas MD Anderson Cancer Center also notes that the overall cancer risk for teens remains low, even though using hormonal birth control minimally increases the risk of developing cancer.

If you use hormonal birth control and you’re concerned about your cancer risk, please discuss your options with your doctor before stopping your birth control.

According to research, including a 2014 study, use of oral contraceptives increases the risk of early onset breast cancer in people under 25 years old who have a BRCA gene mutation.

Doctors should exercise caution before recommending oral contraceptives to someone in this group.

That said, an increased breast cancer risk (relative to the general population) is just one of many factors to consider before deciding on the right birth control method.

Teens going through the earlier stages of puberty may notice lumps (known as breast buds) near their nipples. Tenderness and soreness are also possible. These occur during normal breast development and aren’t a cause of concern on their own.

Your period can also cause tenderness and soreness in the breasts.

The most common type of breast cancer found in teens is secretory adenocarcinoma. This is generally a slow growing, nonaggressive cancer.

Though there’s little chance of this type of cancer spreading to other parts of the body, spread to local lymph nodes has been noted in a few cases.

Most breast lumps in teenage girls are fibroadenomas, which are noncancerous. An overgrowth of connective tissue in the breast causes fibroadenomas.

The lump is usually hard and rubbery, and you can move it around with your fingers. Fibroadenomas account for 91 percent of all solid breast masses in girls younger than 19 years old.

Other less common breast lumps in teens include cysts, which are noncancerous fluid-filled sacs.

Banging or injuring breast tissue, possibly during a fall or while playing sports, can also cause lumps.

If you feel anything unusual in your breast, see your doctor. They will ask:

  • about your family’s medical history
  • when you discovered the lump
  • if there’s nipple discharge
  • if the lump hurts

If anything looks or feels suspicious, your doctor will have you undergo an ultrasound. This test uses sound waves to see into your breasts. It can help determine whether a lump is solid, which is an indication of cancer.

If it’s fluid-filled, that will most likely indicate a cyst. Your doctor may also insert a fine needle into the lump to draw out tissue and test it for cancer.

Should teenagers have mammograms?

Mammograms aren’t recommended for teens for two reasons:

  • Teenage breasts tend to be dense, making it hard for traditional 2-D mammograms to detect lumps.
  • A mammogram exposes breasts to radiation, which can lead to cell damage, especially in young, developing bodies.

Doctors treat secretory adenocarcinoma by surgically cutting out the cancer while sparing as much breast tissue as possible.

Doctors consider chemotherapy and radiation on a case-by-case basis. The risks these treatments pose to young, developing bodies may outweigh the benefits.

Depending on the type of therapy and how long it lasts, it can affect your fertility and increase your chances of other cancers.

You can still breastfeed after breast or nipple surgery. However, some people may produce less milk than others.

The ACS no longer recommends regular breast self-exams, since there’s no evidence that they help reduce breast cancer deaths.

However, knowing how your breasts normally look and feel can help you identify any changes early on. Take notice of the following:

  • lumps
  • breast thickness
  • discharge
  • breast abnormalities
  • skin dimpling
  • sores

Once you’ve established a baseline for how your breasts look and feel, it’ll be easier to identify any changes in the future.

If you do notice any changes, or if anything causes you worry, let your doctor know. They can determine if there’s cause for concern.

It’s common to see asymmetry in breast size, which can be normal.

A note on breast exams

The American Cancer Society (ACS) no longer recommends regular clinical breast exams or breast self-exams. There’s little evidence that these exams help reduce deaths from breast cancer in women at average risk for the condition.

However, these exams may still be performed in certain scenarios.

For instance, some healthcare professionals may choose to perform clinical breast exams and counsel women on risk and early detection, in particular those at a higher-than-average risk for cancer. In addition, some women might prefer to use routine breast self-exams as a way to track possible changes to their breasts.

Researchers estimate that the 5-year relative survival rate for 15- to 19-year-old U.S. girls diagnosed between 2009 and 2015 is 85 percent. This means that they’re 85 percent as likely to live another 5 years as 15- to 19-year-old U.S. girls without breast cancer.

The 5-year relative survival rate for women 20 years old and older who were diagnosed between 2011 to 2017 is 90.3 percent.

Because breast cancer is so rare in teens, doctors and teens may adopt a watch-and-wait approach, and delay treatment. That may account for the lower survival rate for teens with breast cancer compared with adult women with the condition.

Breast cancer is extremely rare in teens, but you should still check abnormalities. Adopting certain habits now can also help prevent breast cancer later. These include: