Differential Diagnosis for a Painful Breast Lump in a 12-Year-Old
Single Most Likely Diagnosis
- Breast bud tenderness or Thelarche: This is the most common cause of breast lumps in adolescent girls, occurring as a result of hormonal changes during puberty, leading to breast development and sometimes tenderness.
Other Likely Diagnoses
- Fibroadenoma: A common benign breast tumor in adolescents, often presenting as a firm, mobile, and sometimes tender lump.
- Cyst: Breast cysts can occur in adolescents, although less commonly than in adults, and may cause pain, especially if they become large or rupture.
- Infection or Abscess: Breast infections can occur in adolescents, particularly if they have a history of trauma, surgery, or are breastfeeding (less common in this age group).
- Fat Necrosis: Trauma to the breast can cause fat necrosis, leading to a painful lump.
Do Not Miss Diagnoses
- Breast Cancer: Although extremely rare in adolescents, breast cancer must be considered to avoid delayed diagnosis. It's crucial to investigate any persistent or growing lump.
- Phyllodes Tumor: A rare type of breast tumor that can be benign, borderline, or malignant. It tends to grow quickly and can cause pain.
- Potts Disease (Tuberculous Mastitis): In areas where tuberculosis is common, tuberculous mastitis should be considered, especially if there's a history of exposure or systemic symptoms.
Rare Diagnoses
- Hamartoma: A benign breast tumor composed of a mixture of glandular, fibrous, and fatty tissues, which is rare in adolescents.
- Papilloma: Benign tumors growing in the milk ducts of the breast, which can cause a lump and are more common in older women but can occasionally occur in adolescents.
- Lipoma: A rare benign tumor made up of fat tissue, which can occur in the breast and cause a lump.