ABSTRACT
The differential diagnosis of bloody discharge in children and adolescents includes mammary duct ectasia, chronic cystic mastitis, intraductal cysts, and intraductal papillomas. When evaluating an adolescent, a discussion of breast self-awareness should be part of the examination. Many congenital and neoplastic breast disorders present in childhood and adolescence. Patients with breast disorders should be promptly diagnosed and counseled on the significance of the anomaly so that potential treatments can ensue in a timely manner. Long-term follow-up has shown that patients with isolated premature thelarche develop normal breasts at puberty and are at no increased risk for disorders or tumors of the breast. Systemic diseases and endocrine disorders can be associated with lack of estrogen and thus lack of or delayed breast development. Neurogenic lactation occurs as a result of disorders of the chest wall, thorax, or breast.
