A 14 year old healthy girl of normal height and weight for age complains that her right breast has developed twice the size of her left breast since the onset of puberty at the age of 12. Both breasts have a similar consistency on palpation with normal nipples areolae. The most likely cause for these findings is :
Ans. is 'b' i.e. Virginal hypertrophyRef: C.P.D.T 16th/e, p1128, 133Nelson 16th/e, p573, 1665Here we have to looks for a rapidly developing breast mass in adolescent which is similar in consistency to the normal breast and shows no other abnormalityLet's consider each option one by one -Cystosarcoma phyllodes -This tumor occurs predominantly in premenopausal women around 40 yrs of age. However these may occur in adolescents too. It presents as rubbery mass and on inspection it shows big swelling with tense glistening skin over it.Fibrocystic breast diseaseFibrocystic disease is also rare in adolescent. It is usually seen in women of 20-40 yrs. Of age. It can be easily ruled out as it presents with multiple masses associated with pain and tenderness.Early carcinoma -Carcinoma is rare in adolescents. Carcinomas can be easily ruled out as it presents with hard lump.Virginal hypertrophy -Although it often presents as b/l breast mass, yet the typical history of rapidly developing breast mass and similar consistency of both the breast makes the diagnosis of virginal hypertrophy likely.Virginal hypertrophy is a massive enlargement of usually both the breasts. It can also be unilateral. It usually occurs due to an alteration in the normal sensitivity of the breast to estrogenic hormonesTreatment - Reduction mammoplastyFrequency of Breast masses in adolescentsFibroadenoma - 54%Virginal hypertrophy - 13 %Fibrocystic or proliferative breast lesion - 24%Cystosarcoma phyllodes - 2%
Cystosarcoma phyllodes
Virginal hypertrophy
Fibrocystic disease
Early state of carcinoma
Miscellaneous (Breast)