Q: When my daughter went for a sports physical, the doctor found a lump in her breast. He scheduled another visit in a month, but shouldn't she get a mammogram?
A: Unless there is a strong family history of early-onset (before menopause) breast cancer in your family, the odds are overwhelming that your daughter has either a small cyst or a fibroadenoma in her breast.
Both are benign -- that is, non-cancerous conditions. A fibroadenoma is a localized area of thickened tissue in the breast and very common in teen-agers. In contrast, the incidence of breast cancer among teen-agers is quite low: Fewer than 150 cases are reported annually in American women under age 25.
Mammograms are very effective for evaluating breast lumps in older women. Denser breast tissue of teen-agers renders this test less useful in your daughter's case. Instead, a repeat exam a few days after a menstrual period is more effective.
Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.