Breast Development
Breast development is one of the first visible signs of the onset of puberty in girls. It usually begins between the ages of eight and thirteen, shortly before the growth spurt.
Female breast development is measured in stages based on contour (shape), not size. There are five distinct stages of breast development, called Tanner stages: prepubertal—no signs of breast development; early breast budding; elevation of the breast and areola (the pigmented ring surrounding the nipple); projection of the areola and nipple above the breast itself; mature breasts—areola flattened to the level of the breast with only the nipple projecting.
Breast size is not related to sexuality, femininity, or fertility. Nonsurgical means of increasing the size of small breasts (such as creams, pumps, and massage techniques) do not work. Hormonal medications, including oral contraceptives, sometimes cause an increase in breast tissue. Exercise can increase the size of chest muscles, but not the breast itself. Although breast size can be increased surgically, serious health problems have been reported in connection with the use of silicone implants.
Abnormally large breasts can result when developing breast tissue is unusually sensitive to estrogen. Very large breasts can lead to a number of problems ranging from neck and shoulder pain to extreme self-consciousness. If such enlargement is physically or psychologically debilitating, a portion of the breast tissue may be surgically removed even before the end of puberty.
Asymmetry
In many girls, one breast may develop earlier or faster than the other or one breast may seem firmer or more tender than the other. This asymmetry is most pronounced when the breasts are growing rapidly. In most cases, however, the breasts will resemble each other when they are mature.
Discharge, Pain, and Masses
The secretion of breast milk is called galactorrhea. Milk secretion not related to childbirth or nursing (or occasionally abortion or miscarriage) requires medical attention. Galactorrhea accompanied by amenorrhea (absence of menstrual periods) could signal the presence of a pituitary tumor.
Breast pain is a normal part of the menstrual cycle and usually subsides as a menstrual period ends. Breast pain or tenderness not associated with menstruation, however, should be reported to a physician. In addition, all adolescent women should learn how to examine their own breasts. Breast examination techniques can be learned from a nurse, a doctor, or even a pamphlet. Although breast cancer is rare in adolescents (less than 1% of lumps discovered in teenagers' breasts are cancerous), any lump that persists for more than a month should be reported to a doctor. One in ten adult women will eventually develop breast cancer, so establishing the habit of monthly self-examination during adolescence may prove lifesaving later on.
For Further Study
Books
Love, Susan M. Dr. Susan Love's Breast Book. Reading, MA: Addison-Wesley, 1995.
McCoy, Kathy, and Charles Wibbelsman. The New Teenage Body Book. New York: The Body Press (Putnam), 1992.
Organizations
American Cancer Society
Address: 1599 Clifton Road NE
Atlanta, GA 30329
Telephone: 1-800-ACS-2345
(Pamphlets on monthly breast self-examination)
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