Abnormal Breast Development
Asymmetric breasts are the rule rather than the exception. When the asymmetry is significant, plastic surgeons may be able to help “balance the breasts.” Asymmetry can be present since birth as in Poland’s Syndrome or breasts may develop with differing shapes or amounts of breast tissue. An unusual source of breast asymmetry is a giant fibroadenoma, where a benign mass rather than breast tissue is the source of enlargement. Physical examination can usually identify the source of asymmetry. Asymmetry, once noted, rarely changes.
Surgeries can be planned with the patient to provide balance to the two breasts. Correction may involve making larger breasts smaller, making smaller breasts larger or combinations of the two. The surgeon and patient can develop a personalized approach to breast asymmetry that suits the unique circumstances of the patient. The timing of surgery is dependent on the amount of asymmetry and needs of the patient.
Breast masses in adolescent girls are infrequent and usually benign. The most common breast lump—in approximately 70% of cases—is a fibroadenoma. In fact as many as 15% of patients may have multiple fibroadenomas; these masses are smooth, mobile, and round; fortunately, they are usually benign. The masses may occasionally become larger just before the patient's menstrual period. Careful monitoring of these lumps, typically every one to three months, may be all the treatment needed. Ultrasonography is often used to help confirm the diagnosis. Rarely a biopsy may be performed if the patient and family request it.
Like fibroadenoma, fibrocystic lumps in the breast are very common in the adolescent girls. Physical findings may include a solitary breast lump or many small lumps throughout. Some girls notice breast tenderness and a feeling of “heaviness,” especially before their menstrual periods. Avoiding caffeine is recommended; also, one tablespoon at bedtime of evening primrose oil may be helpful in reducing breast discomfort.