Why do children's breasts suddenly become bigger when they wear thin clothes in summer?

Award-winning works (article category) of the Health Management Committee's "Popularize health knowledge, advocate healthy life" popular science collection

Author: Lu Yunshu

Unit: Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine

At the beginning of summer vacation, our breast surgery clinic welcomed a peak of young patients. Most of the patients who came for treatment were adolescent girls aged 12-15, and there were also many boys. Anxious mothers generally responded that after a winter, children found various breast problems after putting on T-shirts in the summer. Girls are often dragged by their mothers to come for treatment, mainly with abnormal conditions such as breast pain, asymmetric breast size, itchy skin in the areola area, and lumps felt in the breasts. Boys often bring their mothers to see a doctor because their classmates laughed at their protruding and enlarged breasts for looking like girls, which affected their image as boys and their confidence in making friends. With the change of lifestyle and eating habits, breast development no longer only occurs in girls, and more and more boys are also beginning to see a doctor for breast problems. Focusing on some common problems in outpatient work, we will discuss the breast development problems that need to be paid attention to during the growth of children.

1. If a boy’s breasts develop in a feminine way, is it a tumor?

After several months of online classes, several embarrassed boys come to the breast clinic every day, led by their anxious mothers. After asking about their medical history, it is basically that during the online classes, their exercise volume decreased significantly and their weight increased significantly. After a few months, the boys found that their breasts had grown bigger. The boys are embarrassed about their image, while their mothers are anxious about whether breast tumors will occur.

In fact, most adolescent male breast development is physiological and related to the disorder of estrogen androgen during adolescence. About 50% of them can disappear on their own as they grow. Obesity can increase the production of estrogen in the body, which to a large extent promotes breast development. The most common manifestation is a visible chest bulge, which can even reach the size of an adult female's breast. Doctors can usually find glandular hyperplasia and hypertrophy in the breasts with tenderness through physical examinations. Enlarged areola and pigment deposition can be seen in patients with long development time. Routine ultrasound examinations can show hyperplastic glands and confirm the diagnosis. Of course, while making the diagnosis, it is also necessary to check the development of adolescent male sexual characteristics to rule out abnormal breast development caused by abnormal pituitary, hypothalamus, thyroid, adrenal glands, and liver function.

The early stage of physiological development of boys' chest, such as when the apple is still in the core stage, we call it "breast core". Early detection, timely intervention, removal of exogenous inducements, and active exercise can effectively control the further development of the breast. If you miss early medical treatment, when the breast glands are fully developed, such as when the apple is fully grown and formed, it will be difficult to remove the mature glandular tissue by weight loss. In such cases, it is necessary to have sufficient psychological communication with the child to relieve the psychological barriers of inferiority and self-disapproval. If the psychological barrier cannot be resolved, laparoscopic minimally invasive surgery can be considered to remove the developed glandular tissue, restore the child's normal boy chest, and rebuild the child's gender confidence.

2. The mother feels that her daughter’s breasts are too small or asymmetrical. Can she take medicine to enlarge her breasts?

For adolescent girls aged 15 or 16, their breasts are basically developed. Mothers often bring their daughters to the doctor to ask if there is any way to enlarge their breasts because their breasts are too small. In such cases, we first need to give the child a physical examination. First of all, it is necessary to rule out the situation of skeletal dysplasia in the chest. During the examination, it is often found that the child has unilateral or bilateral rib collapse (commonly known as: funnel chest). The breasts of these girls are developed normally, and it is the depression of the ribs that causes the appearance of the breasts to become smaller, just like the collapse of the building caused by the collapse of the foundation. Secondly, a complete examination of the breasts needs to rule out bilateral asymmetry caused by a huge tumor in one breast. Finally, ask whether there is a prone sleeping or other bad body habits. Improving bad posture can appropriately improve the appearance of the chest. After excluding disease factors, we will tell parents not to be overly anxious and not to take hormone drugs to enlarge the breasts. The child's breast structure develops normally and will not affect the breastfeeding function in adulthood.

3. The child’s areola skin is watery. What’s wrong?

After entering spring, nervous mothers often say that they see yellow mucus on their children's bras, is it a tumor? After a physical examination of the child, it is often found that one or both areolas have eczema, accompanied by skin itching, rash, desquamation, a small amount of fluid exudation and other typical eczema manifestations. Further inquiries often reveal that the child's skin also has eczema. After alleviating the mother's false alarm, we will inform the parents to maintain skin care, go to the dermatology department for treatment and use regular anti-eczema drugs, and pay attention to allergens and relieve mental stress.

4. What should I do if my child has inverted nipples?

One or both sides of the child's nipple are inverted, which is also a concern for mothers. First of all, children's nipple inversion often occurs in infancy and is related to congenital structural maldevelopment of the breast and genetic factors, so there is no need to be overly nervous. Secondly, the degree of nipple inversion varies. Generally, mild to moderate nipple inversion will not affect the breastfeeding function in adulthood. Only severe nipple inversion may cause difficulty in milk discharge and local inflammation and infection. Finally, surgical treatment is not recommended for nipple inversion in minors. Nipple correction surgery can cause damage to the central milk ducts and affect normal physiological functions in the future. In daily life, you need to pay attention to the cleaning of the local area of ​​the nipple depression to prevent nipple secretions from retrogradely entering the breast and causing local infection.

5. If a large lump is found in the breast, should it be removed surgically?

The incidence of breast lumps during adolescence is not high, but once discovered, they are often large lumps larger than 3 cm. There are probably two common reasons. One is that the strong secretion of estrogen during adolescence promotes the occurrence of breast tumors. The other is that children are too shy to let their parents check, and often they tell their parents only when they touch a large lump. Fortunately, these large lumps during adolescence are almost all benign. Whether surgical removal is needed or not, the size of the lump must be considered first. Generally, surgical removal is recommended for lumps larger than 2 cm. Secondly, the location of the lump must be considered. A lump in the central area will affect the development of the milk ducts and affect the breastfeeding function in the future, so surgical treatment is also recommended. From clinical experience, breast lumps during adolescence are prone to "crazy growth", so early surgical treatment is recommended. Removing the lump as soon as possible can relieve the pressure of the lump on the surrounding mammary glands, allowing the adolescent breasts to continue to develop normally without affecting the physiological function in adulthood.