Red flags & when to go in person for Breast Lump - Triage

Audience: pediatric

A breast lump in a child or adolescent can be concerning for parents and caregivers. Many breast lumps in young people are benign and related to normal development, such as hormonal changes during puberty. Telemedicine can help assess the lump, gather history, and provide guidance. However, certain signs require prompt in-person evaluation to rule out serious conditions. This guide explains when telemedicine is suitable and when to seek face-to-face care. It highlights important warning signs, preparation tips for telehealth visits, and common follow-up steps. Early recognition of red flags ensures timely and appropriate care for pediatric breast lumps.

Red flags — go in person / ER

• Rapid increase in lump size over days to weeks requires urgent in-person evaluation.
• Signs of infection such as redness, warmth, tenderness, or fever need prompt medical attention.
• Skin changes like dimpling, nipple discharge, or ulceration around the lump should be assessed face-to-face immediately.

What telemedicine can do

• Initial history taking about the lump and symptoms.
• Visual inspection of the breast area via video if privacy allows.
• Providing education on normal breast development and reassurance.
• Determining if urgent in-person care is needed based on symptoms.

What telemedicine cannot do

• Performing a physical breast exam to assess lump texture and mobility.
• Ordering and interpreting imaging studies such as ultrasound or mammography.
• Performing biopsy or other diagnostic procedures.
• Managing acute infections requiring drainage or intravenous antibiotics.

Understanding Breast Lumps in Children and Adolescents

Breast lumps in young people often result from normal growth during puberty, such as benign cysts or fibroadenomas. These lumps are usually painless and slowly develop. However, some lumps may need further evaluation to exclude infections, trauma, or rare tumors. Knowing the typical features helps decide if telemedicine is appropriate.

When Telemedicine Can Help

Telemedicine allows healthcare providers to ask detailed questions about the lump, observe visible signs via video, and review any symptoms your child has. This can help determine if the lump appears typical or if further tests are needed. Telehealth is useful for initial assessment and reassurance in many cases.

Red Flags That Need In-Person Evaluation

Certain signs mean your child should see a healthcare provider face-to-face promptly:

If any of these occur, seek in-person care immediately.

Preparing for a Telemedicine Visit

To make the most of your telehealth appointment:

This preparation helps the provider assess the situation accurately.

After the Telemedicine Visit

Based on the telemedicine assessment, your provider may:

Follow all instructions carefully and report any new symptoms promptly.

How to prepare for your tele-visit

• Ensure a private, well-lit area for the telemedicine visit.
• Have a family member assist if needed for camera positioning.
• Note when the lump was first noticed and any changes since then.
• Observe and be ready to describe any associated symptoms like pain, redness, or fever.
• Have your child's medical history and any previous breast-related issues available.

After your tele-visit

• Follow provider’s advice on monitoring the lump and symptoms.
• Schedule in-person visits if recommended for physical exam or imaging.
• Seek immediate care if red flag symptoms develop after the tele-visit.
• Keep a symptom diary to share with healthcare providers during follow-up.
• Maintain open communication with your healthcare provider for any concerns.

FAQs

Are breast lumps common in children and teenagers?

Yes, breast lumps are relatively common during puberty due to hormonal changes. Most lumps in this age group are benign and related to normal breast development.

Can telemedicine diagnose the cause of a breast lump?

Telemedicine can help assess symptoms and decide if further in-person evaluation is needed, but it cannot replace a physical exam or imaging required for diagnosis.

When should I take my child to see a doctor in person?

If the lump grows quickly, is painful, shows signs of infection (redness, warmth, fever), or if there are skin changes like nipple discharge or dimpling, seek in-person care promptly.

What tests might be done during an in-person visit?

A healthcare provider may perform a physical exam and order imaging tests such as an ultrasound to better understand the lump. In some cases, a biopsy may be needed.

Is breast cancer common in children?

Breast cancer is extremely rare in children and adolescents. Most breast lumps in this age group are benign, but any concerning signs should be evaluated by a healthcare professional.

Sources

1. Breast Lump in Children and Adolescents — MedlinePlus, U.S. National Library of Medicine.
2. Breast Masses in Adolescents — American Academy of Pediatrics.
3. Breast Lumps: When to See a Doctor — Mayo Clinic.
4. Breast Masses in Pediatric Patients: Evaluation and Management — National Library of Medicine.

This telemedicine guidance is for educational and triage purposes only and is not a substitute for professional in-person medical evaluation, diagnosis, or treatment. If you have concerns about a breast lump in your child, especially if red flag symptoms are present, please seek prompt in-person medical care.