STORY BYYour world comes crashing down in the one second you hear your frantic 18-year-old daughter shriek, “Mom, I feel a lump!”
Shocked, you think, surely she’s too young to have a breast lump. Surely she’s too young for breast cancer…
As if the teen years aren’t tough enough, adding distinctly “grown-up” problems such as the fear of breast cancer can be overwhelming for daughters and parents.
“This is not a time for panic,” according to Dr. Christine Cocanour, associate professor of surgery at the University of Texas Medical School at Houston. “Most lumps in children and teens are not cancerous and are not serious, but this doesn’t mean that a parent should ignore the situation if their daughter does find a breast mass.”
Cocanour says that lumps of any kind are a good reason for a visit to your doctor. “It is natural for parents to worry, but learning the facts of their daughter’s situation is a step in the right direction.”
Most benign breast lumps are caused by fibrocystic changes in the breast, a normal part of the menstrual cycle. These types of lumps are fluid-filled cysts.
The most common type of mass in women under the age of 20 is fibroadenomas, which are harmless benign breast lumps. These lumps are usually smooth, rubbery or hard and they move easily with the breast tissue. Not attached to the surrounding tissue and skin, these lumps are moveable when manipulated by fingers.
Ultrasound is the best diagnostic tool because these lumps and abnormalities have a specific appearance. “We often recommend a core needle biopsy to confirm the diagnosis,” she says. “Unless the lump is causing discomfort or is large enough to cause distortion, there is not a reason to remove every fibroadenoma or cyst.” Mammograms are not usually recommended for women under age 20.
While most breast lumps are benign, it is vital to identify those that are not. When a lump is growing, or is hard, immobile and causing skin deformities, your doctor will suggest a course of action.
“Women of all ages can get breast lumps, but lumps are more common among women during middle age,” she adds. “It may be comforting for a teen and her parent to understand that having a lump as a teen does not increase your chance of getting breast cancer.”
Does the latest trend of teens drinking Frappuccinos raise alarm bells about caffeine’s relation to breast lumps? “There is no conclusive evidence of a link between caffeine consumption and fibrocystic changes in the breast,” says Coconaur, “and when I refer to caffeine, I include all dark colas and chocolate, not just coffee.”
But one fashion trend is a big No-No in Coconaur’s book: “We strongly urge our young patients to avoid body tattoos and body piercing. A nipple ring on a breast or piercing of a tongue can easily lead to infection and pose a risk for Hepatitis B or Hepatitis C.”
Any body site can become infected from a piercing or tattoo, but areas that are moist, such as the genitalia and the mouth, or areas that rub against clothing, like the breast, are particularly susceptible.
She emphasizes that all of us, teen girls included, have a responsibility to be proactive when it comes to safeguarding our health.
It is not uncommon for a teen to be too embarrassed—or terrified—to even mention a lump, incorrectly assuming that all lumps are cancerous.
Therefore, the first order of business is to encourage your teen daughter to be aware of any changes in her breast, to know that most lumps are harmless, to conduct a monthly self-exam and to let you know immediately if there is anything unusual.
And you can talk this over with her while you both sip a Frappuccino.
UPDATED: 11-10-2003
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Dr. Christine Cocanour is an associate professor of surgery with the UT Medical School.
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Summer Carbon Monoxide Dangers
Generators used to cool off homes in hot summer months can cause death through carbon monoxide (CO) poisoning.
CO is an odorless, colorless gas that can kill or seriously and permanently injure people who inadvertently breathe in the noxious fumes emitted from generators in an enclosed space.
During hurricane season, emergency rooms see a rise in cases of CO poisoning from people bringing generators into their homes to provide power, often for cooling fans as well as cooking.
“During Hurricane Rita, we had a family of five die here in Houston for CO poisoning,” reminds UT Medical School Hyperbaric Medicine expert, Dr.Caroline Fife. “The Center for Disease Control and Prevention tracked deaths from CO poisoning due to combustion engines after Katrina and Rita and there was a dramatic increase.”
“Teak surfing”—holding on to the back of a power boat’s swim platform and being towed—is another danger. The boat’s exhaust pipe is in the face of the swimmer.
People riding in the back of pick-up trucks are at risk, too. Numerous cases have been cited of children poisoned by riding beneath tarpaulins or enclosed “cabs” in the back of the truck. In these cases, the trucks had a leak in the exhaust system or a rear-exiting tail pipe, not a side exit.
Fife also has seen this in boats with malfunctioning exhaust systems. She urges doctors and bystanders to pay special attention when groups of people begin to feel ill at the same time, particularly severe headache and nausea. Children often become symptomatic before adults.
“People associate CO poisoning with cold weather and northern states, but in the South, we see it a lot in summer with people just trying to stay cool,” Fife says.
