If your daughter finds a lump in her breast, it can be very frightening for both you and her, particularly as breast cancer is always in the news. You may ask yourself, “How come my 9 year old has a lump under her nipple?” However, there’s no need to worry as this lump in child’s breast is unlikely to be anything serious. Less than 0.1% of breast cancer cases occur in people under 20. Hormonal changes are much more likely to be the cause of a lump under nipple in female child. However, for a clear diagnosis of your child’s condition, make an appointment to see your doctor.

What May Cause Lump in Child’s Breast?

1. Puberty Breast Development

The first visible sign of breast development in girls is the emergence of a lump under nipple. Female child will have these breast buds which usually appear at age of nine or ten, although it can be earlier or later. Precocious puberty is not usually suspected unless a girl starts developing breasts before the age of six (African American girls) or seven (Caucasian girls).

2. Breast Cyst

Cysts are pockets of body tissue filled with air or fluid that can develop within the breast, most commonly due to the blockage of glands. Breast cysts are usually found in women aged 35-50, but may develop in adolescent girls. The cysts can appear suddenly, and may become swollen and tender just before menstruation. They may be soft or hard. Once a cyst is diagnosed, it can be treated by aspiration, a process to drain the fluid.

3. Fibroadenomas

Fibroadenomas are benign lumps that occur at all ages, but are most common in women between 16 and 24. They are solid, smooth, firm, and rubbery, moving around freely when you touch them. Fibroadenomas can develop anywhere within the breast and may grow to various sizes. Doctors usually identify fibroadenomas through feeling around the breast tissue, but may confirm the diagnosis through mammogram, ultrasound, or fine-needle aspiration.

4. Breast Abscess

Breast abscesses can occur in preadolescent girls. The girl may feel a red tender lump in her breast. The abscesses usually develop due to staphylococcus aureusinfection which is increasingly resistant to methicillin antibiotics (MRSA). Treatment frequently involves needle aspiration, antibiotics, and/or surgical draining. However, antibiotics can be ineffective when the abscess is caused by MRSA and surgical operations may cause breast deformation as puberty progresses.

5. Benign Fibrocystic Change

Over half of all women will experience fibrocystic change in their breasts over the course of their lifetime. Fibrocystic lumps can give rise to discomfort and pain, though this isn’t always the case. The cause of fibrocystic change is still unknown. If the mass doesn’t disappear over the time, the doctor may perform a thin needle aspiration of the lump.

What to Do If My Child Has a Breast Lump?

You may wonder, “Why is it that my 9 year old has a lump under her nipple?” and it can be very distressing. However, there are some steps she can take to maintain good overall health during puberty:

  • Don’t smoke and avoid exposure to second-hand smoke.
  • Don’t drink alcohol.
  • Don’t take steroid supplements or steroid-containing medicines (e.g. for asthma treatment) if possible.
  • Practice daily physical exercise.
  • Eat a nutritious, well balanced diet.
  • Maintain a healthy weight.
  • Don’t get piercings or tattoos on the breasts.

In most cases lump in child’s breast is a part of the normal breast development process, clinically measured by the Tanner scale. The scale describes five stages of breast development, and you can refer to it to help determine what stage your daughter is at.

Stage Age Main Breast Changes
Tanner I            <10

The areola is along the contours of the skin on the chest.

There isn’t any glandular tissue in the breasts.

Tanner II 10-11.5

Small breast buds develop, with surrounding glandular

tissue. The areola starts to become wider.

Tanner III 11.5-13

The breast tissue now goes beyond the areola,

and starts to grow out from the chest.

The areola is still increasing in size,

but is not elevated from the rest of the breast.

Tanner IV 13-15

The breasts continue to grow and elevate themselves

from the chest. A second prominence consisting of the

areola and nipple starts to project out from the breast.

Tanner V >15

The breasts have achieved their adult size.

The areola is now on a level with the rest of the

breast with the nipples sticking out.

Please remember that this is just a guide, and there will be variation between girls, due to ethnic and genetic differences.

When to See a Doctor

If your child has any of the following signs in addition to the breast lump, you will need to make an appointment to see a healthcare professional as soon as possible:

  • The lump isn’t situated directly under the nipple.
  • The lump has a diameter more than 1.5 inches (4 cm).
  • The lump doesn’t go away after 2 years.
  • The lump occurs when the girl is over 15 years, especially if she has finished puberty.
  • The lump is attached to the chest wall, feels hard, or is unmovable.
  • Your child has dimpled, ulcerated, or discolored skin lying over the lump.
  • Your child has blood, milk, or other liquid leaking from the nipples.
  • Your child has other disease symptoms, e.g. fever, night sweats or weight loss.

A breast lump accompanied by these symptoms will definitely require further assessment, in addition to the usual periodic physical assessments your child undergoes during puberty.