Understanding breast health in young girls

Bavina Sookdeo

When it comes to breast health, most people associate the topic with adult women – particularly those in their 30s and 40s.

However, as Dr Rajen Rampaul, breast oncologist and breast reconstructive surgeon, explains, breast-health awareness should begin much earlier, even in childhood.

“When we talk about young girls,” he said, “we’re referring to those between eight or nine years old up to about 14 or 15 – this is where we start to see, alongside the development of her monthly menses (periods), the development of the breast bud.”

Rampaul, who has dedicated decades to breast care and cancer treatment, is the medical director at Pink Hibiscus Breast Health Specialists, a centre known for its comprehensive approach to breast wellness.

Breast issues, not problems

He said breast changes during puberty are almost always normal – yet they often cause alarm among parents and young girls.

“The most common breast-related issues in this age group are connected with physiological development. And it’s right to call it ‘issues’ – because these are not health problems.”

He said in his practice, it is common for a young girl to come in because she is feeling a breast lump, but in reality, it is the breast bud that is becoming a little more obvious.

“Additionally, with the development of her monthly cycles, these breast-bud developments tend to give discomfort or pain, and that is a usual concern with the parents.”

But, he stressed, “Unequivocally, breast cancer is not a concern in this very young group.”

Rampaul emphasised that breast pain in young girls is perfectly normal during development. It can occur either cyclically or non-cyclically: it’s often linked to the hormonal changes that accompany puberty.

But he said while such discomfort is typically harmless, it is still advisable for parents to consult a doctor so they can better understand their daughter’s hormonal and physical development.

Cancer least likely

The most common breast condition among children and adolescents, he said, is a fibroadenoma – a benign (non-cancerous) lump commonly found in young women of West Indian descent. “Fibroadenomas come in various types, such as giant or juvenile fibroadenomas. They are not cancerous and rarely a cause for concern.”

He stressed that breast cancer in this age group is extraordinarily rare.

“I have never seen a patient under the age of 16 with breast cancer. Medical literature may record a single case worldwide – but this condition is almost unheard of in young girls.”

Still, he urged parents to seek medical advice whenever they notice something unusual – not because cancer is likely, but because reassurance and education are vital.

“Anything that worries the child or parent warrants attention,” he emphasised. “Reassurance is extremely important in this age group for both parties.”

When medical evaluation is needed, ultrasound is the preferred imaging tool.

“A clinical examination is safe and will not bring harm in any form or side effect to the young, developing girl.”

Rampaul said an ultrasound is also a safe and accurate test for this age group, as it would not cause any risk from radiation.

“It is painless as well, which is a particularly important aspect when advising a medical test.”

It’s the hormones

Pubertal hormones are the main driver of breast development and related discomforts.

Rampaul explained, “Hormonal changes during puberty are the cornerstone for why we see breast pain in this age group. These changes can cause lumpiness that may mimic true lumps, which often causes concern.”

He also pointed out that polycystic ovarian syndrome (PCOS) is a condition that can influence breast health.

Those who are aware of this condition would know, he said, “They would have erratic hormonal cycles, as the ovaries are not functional as they should be.”

Rampaul said this has an influence on the breast itself, so such patients can often have breast pain and lumpiness caused by the unusual behaviour of the ovaries and hormone production.

While family history plays an important role in assessing breast cancer risk in adults, Rampaul assured that genetics are not a factor during puberty.

“At this particular age, family history doesn’t play a role, and I would not recommend putting that burden of worry on a young child.”

Knowledge is key

Education is the first step in helping parents approach their daughters’ breast health with confidence and understanding. Rampaul said parents should take the time to learn about the normal changes that occur during puberty – how hormonal shifts influence both the menstrual cycle and breast development.

Pain, tenderness and minor changes in breast size or shape are typically normal and can be managed with reassurance rather than alarm, he said.

He added, though, “What I see sometimes at this stage is that one breast may develop a little more than the other, causing asymmetry. The parents may view this as one breast getting larger than the other.

“(But) what will happen is that both breast sizes will become equal as the girl goes through her puberty, and there’s often no need for further concern.”

He believes schools and communities play a vital role in promoting breast-health awareness in a way that informs rather than frightens.

“Schools are excellent platforms to provide education about breast development and benign breast changes. Young girls should learn what’s normal in their bodies and how these changes fit into growing up.”

What teens need

At this age, lifestyle factors like diet and exercise have minimal influence on breast development itself, though they remain vital for overall health.

“The physiological capabilities of such a young girl can often deal with dietary and obesity impacts to the point that it does not influence her breast development,” said Rampaul, who added that healthy habits should still be encouraged for general well-being.

However, he cautioned against overemphasising cancer awareness at this stage.

“There’s no need to speak extensively about breast cancer in this age group.

“Instead, focus should be on normal development and benign conditions like hormonal breast pain or fibroadenomas.

“Helping girls understand their bodies early helps create lifelong awareness. They grow into women who are confident, informed and unafraid to take charge of their health.”