What about if you have no lumps, just pain? If you get periods, it’s very common to have sore/achy pain in your breasts around/during your period. Breast pain is a common side effect of birth control pills, too, especially when you first start taking them. Breasts with a fibrocystic texture often ache or burn, sometimes a lot—this is often helped by supportive bras, hot compresses, and a pain reliever like ibuprofen or Tylenol. But let’s say your breasts hurt all the time, regardless of your cycle. Most (90%) of the time, breast pain isn’t a sign of any problem, but see a health-care provider anyway, even if it’s just for reassurance that you’re OK. (It turns out that for most breast pain, reassurance actually is the treatment—one study found that in 85% of mild cases and 70% of “moderate cases” of breast pain, being reassured that the pain was not cancer but just a normal thing significantly decreased the intensity the pain.)
But let’s say your provider does find A Thing. The next thing they do will probably be to order an ultrasound and/or a biopsy.
Ultrasound: This usually comes first. Basically, a video game controller covered in hair gel (now you’re excited!) is run over your breast to see the general features of what’s inside. It doesn’t hurt. The picture that’s made from an ultrasound isn’t actually that great‚you know those blurry, blobby pictures of fetuses in utero that expectant parents like to show off? Those are ultrasounds. They can’t tell us what a lump (or anything else) is made of—they’re meant to show your medical provider the general shape, size, and consistency of a lump, so she can determine if she needs to take a closer look. Usually in the form of a biopsy:
Biopsy: A thin needle is inserted into your breast to take out a bit of tissue to examine under a microscope. The downside of this procedure is that a thin needle is inserted into your breast to take out a bit of tissue to examine under a microscope. The upsides are major: (a) it will find out exactly what the lump is made of (definitive diagnosis!) and (b) it can actually treat some lumps (like cysts) by removing enough tissue/fluid that the whole thing disappears. You are given local anesthesia (a shot of numbing medication—like at the dentist) beforehand. Although it’s not specifically for young people, this webMD article answers a ton of questions and goes through each step of the biopsy process. I find it soothing to read this kind of stuff out loud in a grandma-with-a-storybook voice. If you need a grandma feel free to use mine:
Depending on the results of these tests, a few things could happen. If it’s benign (“b-notcancer”), the only treatment might be “watchful waiting,” such as getting ultrasounds every few months to monitor any changes. This is generally what’s going to happen if you have a fibroadenoma or a cyst. Fibroadenomas and cysts are candidates for removal if they’re painful, very large, or you just, like, really really want to get rid of them.
If your lump is malignant, since cancer is so incredibly rare in people your age, you will most likely be referred to a provider who specializes in that disease (technical term for the field: oncology). it’s so rare that the treatment isn’t specialized, and will probably be a combination of surgery, radiation, and chemotherapy. It’s important to know that there isn’t just one type of breast cancer, but many—some more serious than others. And if you do end up being diagnosed with breast cancer, no matter what kind, it’s not a death sentence, and there will be lots of people helping you.
Part Two: Styling
At a certain point in your life, it’s possible that a pair of breasts will sprout from your chest automatically. It’s also possible that this will never happen. If it does, it’s possible that you will love those surprise boobs—but what do you do if you don’t like them, for whatever reason? And what if you’ve longed for them and they never appear?
One way to make yourself comfortable in your body is by going in on some cool chest mods. Most of these modifications have to do with making your chest larger or smaller. Some of them are temporary; some are permanent. Some are spurred by physical problems (your breasts are large enough to cause physical pain); others are wrapped up in gender identity; and some are a matter of emotional happiness or just personal preference. All of these are good reasons!
A big one for many people is that their chest size is incompatible with how masculine or feminine they feel—the northern region can become a major battleground in your civil war between gender identity (how you see your gender) and gender expression (how it’s expressed to others). Sady’s article from before talks about this more in depth, and there’s a veritable carnival of gender-neutral/gender-nonconforming bra and binder wear at Autostraddle. If you want to bind (flatten your chest) completely, Original Plumbing has an excellent how-to on doing it safely.