The real facts about your "girls" and how to take care of them "Well, all my friends think they will never have breastsand it's not funnybecause a lot of girls feel this way." Elena, 13 "I went up two sizes over summer break! I started seventh grade with a 'C' cup. Then my breasts got weird pink stripes on the side. What happened?" Veronica, 12 Girls are as anxious and confused about their breasts as ever. That's why Marisa Weiss, M.D., an oncologist and breast health specialist, and her teenage daughter, Isabel, decided to createTaking Care of Your "Girls."Together, they polled more than three thousand girls and their moms and came up with a surprisingly huge list of worries and misconceptions. Based on their research, you'll get answers to questions like: How do I know when I need to get my first braand what kind should I get? Do big breasts have a higher risk of breast cancer than small ones? How do I get rid of stretch marks? When will my breasts stop growing? How do I examine my own breasts? Will the size of my breasts even out? Do tanning, antiperspirants, wearing a bra at night, and talking on a cell phone cause breast cancer? A groundbreaking book for both mothers and daughters,Taking Care of Your "Girls"is a practical guide to breast care and a girl-to-girl conversation about the feelings and emotions that come with the territory. "This all-in-one, indispensable breast health guide captures exactly what teen girls and their moms really need: practical, easy-to-read, great advice. It's one of the best gifts you can give to your girl." Harvey Karp, M.D., F.A.A.P., author ofThe Happiest Toddler on the Block, board member of Healthy Child, Healthy World

MARISA C. WEISS, M.D., is the president and founder of Breastcancer.org. She currently practices at Lankenau Hospital in the Philadelphia area, where she serves as Director of Breast Radiation Oncology and Director of Breast Health Outreach. Her daughter, ISABEL FRIEDMAN, is a college student at the University of Pennsylvania, who recently graduated from Friends’ Central School in the Philadelphia area and was an assistant teacher at the Children’s School of Science in Woods Hole, Massachusetts.

1

Breast Development:

Hormones, Puffy Nipples, Growing Breasts

There were times I would pray to God, “I will do anything you like, I will do everything my parents say, but I do not want boobs!” It was awful starting to develop. You don’t know what’s going to happen next. And I just wanted to return back to the life I knew without all these problems.

Kelly, 13

I would rather talk to my older sister about my breast development than my parents. She ?doesn’t ask me five hundred follow-?up questions.

Sara, 12

I can tell you, every night—even when I was 11, and my girlfriends were kind of starting to get their period then, starting to develop something, I can remember—I was raised Catholic—I would pray: “Our Father, God bless Mommy, Dad, Mickey, Chrissie, Casey, Kansas”—who was my brother’s dog—“and please God, let me wake up tomorrow with some boobs.” That was the prayer. I can tell you exactly what it was because I spent years saying it.

Lizzie, 18

I knew a lot more about growing breasts than other people. And I was talking with a friend when a mother who was listening in asked, “How do you know all this?” I guess because I grew up the baby in my family, so I was learning about breast development and breast cancer from everybody older than me.

Mary Jane, 14

Well, all my friends think they will never have breasts. And it’s not funny—because a lot of girls feel this way.

Sara, 13

I wished we had the talk about breast development before it occurred, not when the breasts first started to appear. We had the menstrual talk, but somehow breasts were left out.

Elena, 12

At my aunt’s house, I pulled my mom aside to privately tell her that my boobs all of a sudden had started hurting. She said, “Ohhhh, you’re growing breasts,” and then she turned around and told my aunt everything I had just said.

Alexandra, 11

Girls in my school must get changed in the main room for gym class. At first some girls tried to sneak off and change in the bathroom, but the teachers caught them and made them change with everyone else. Now we’re all used to it. We have no choice.

Susanna, 12

I started developing before everybody else. Between fifth and sixth grade I grew boobs and grew about six inches taller. It was ridiculous: I was so out of proportion.

Sasha, 18

When I was seven, I liked the whole idea of having boobs because everybody had them. Me and my friends would try on my mom’s bra and laugh about it. We ?didn’t really understand. I guess I thought that one day I’d just wake up and everything would be different. Only later did I realize how awkward the growing-?up part would be.

Lena, 14

When I first got breasts, no one knew because I wore so many layers. A big T-?shirt and a sweatshirt were the perfect solution. I was against even owning a bra. I ?wouldn’t talk about it with my mom or anybody—and when the words came up I just pretended not to hear. My friends and I pretended we were disgusted by the whole idea of a bra, even though secretly we knew we needed one.

Emily, 15

Later, when I started high school, I was thinking that it’s a lot more normal to have breasts there and I wanted to fit in and have fun— so I should just embrace it. But even so, I am still uncomfortable with them.

Megan, 17

The first things that changed about my body when my breasts started to grow were my nipples. They got so puffy I had to wear a tight camisole under my clothes to flatten them down.

Katie, 16

When my breasts began growing, they started showing through my shirts. I went through great lengths to hide them. I’d even use tape.

Lena, 14

[Breasts can even be an issue for boys, as this quote shows!] Our basketball team needed to practice some drills, so the coach divided our team in half: shirts versus skins. I was praying that I would be on the shirt team so no one would tease me about my, um, breasts. But no, of course that didn’t happen. The coach put me on the skins team and ordered me to take off my shirt—but I pretended not to hear. Then he started yelling at me, “Take off your shirt!” I was horrified— completely embarrassed from my head down to my toes. Still I kept my shirt on. There was no way I was going to take off my shirt.

Ben, 16

First Things First

You know how when you’re driving down the highway things pass by so fast, it can all look like a blur? Well, that’s what breast development can feel like if you are a fast bloomer. And have you ever been stuck on the side of the road while other cars whiz by you? That’s what growing breasts can feel like if you’re developing slowly. Plus there are a lot of feelings rolled in: excitement, frustration, curiosity, embarrassment, discomfort, fun, confusion, fear, and hope.

Knowing what to expect will make you feel better and less uncertain. Knowledge really is power. This chapter will give you a “road map” that will help you understand and keep track of your own unique breast development.

Here’s the Scoop

Breast development requires many steps and takes a bunch of twists and turns, starting inside your mom’s uterus, making the greatest progress during puberty, then adding the finishing touches after high school. Let’s tackle each step along the way.

In Your Mom’s Uterus

Breast growth starts when you are barely three weeks—when you’re just a tiny ball of cells called an embryo. Two little ridges of special tissue, called mammary ridges, form on top of your skin between your armpits and your thighs.

The ridges look like two stretched-out letter Cs, lying back to back. Weeks later, they all but disappear except for a small area on each side of your chest. Then, over the last six months of pregnancy, the leftover mammary ridge cells get to work making the very beginnings of your breasts.

First mammary ridge cells build up on top of the skin to form the nipples and the areolas. A nipple is the peak in the center of your breast, while the areola is the round, somewhat darker bumpy skin around the base of the nipple. A small pit or dent forms in the middle of the nipple, like the hole in the middle of a volcano. (Milk comes out of this opening during breast-?feeding, sort of like a sprinkler or shower head.)

While nipple “construction” is under way, other mammary ridge cells dip beneath the surface to create the breast bud—the smallest and simplest version of the breast gland (milk-?making “factory”). Little shoots sprout off the bud like little fingers on a hand. These fingers are the lobules, made up of milk-?making cells. Next, pipes called ducts form between the lobules and the nipple. The ducts are responsible for draining the milk out to the opening in the middle of the nipple. At this stage of the game, the whole breast bud is tiny and too small to feel.

Breast Break

Breast development takes a break between the day you’re born and the start of puberty. Your body has tons of other important work to do as you grow from a little baby into a young girl. It needs this “breast break” in order to grow taller and wider and to develop all of your other body parts.

Puberty

Sooner or later puberty rolls in—the time when your body changes from a girl’s into a young woman’s. A rise in the female hormones estrogen and progesterone gets the whole breast development show restarted. These hormones, made in your ovaries, travel to your breasts, delivering the message to get back to work.

The restarting of breast development is usually the first sign of puberty and the completion of your breast growth marks the end of puberty. All the other changes, like growing pubic hair, getting your period, getting taller, and having your hips get wider, happen in between.

The Breast Bud Forms a Lump

First, the breast bud behind each nipple gets bigger. It can feel like a little stone, pebble, blueberry, or grape. And it can be sensitive, tender, and sometimes painful.

The breast bud can appear in one breast for weeks or months before the bud on the other side starts to grow. One breast bud may be bigger than the other. They might blossom into breasts right away or hang around for a while before they go on to form breasts.

It’s very common for girls to worry about breast cancer when they feel a new lump that ?doesn’t go away—particularly when it’s only on one side. But all of these changes are normal. There’s no need to worry (Chapter 11 will give you a lot more information about this).

The Nipples and Areolas

Get Going

Right after the breast buds start growing, the nipples and areolas get puffy, bigger, and darker. They can also feel itchy, painful, and more sensitive to the touch.

While the breast bud can’t be seen, the puffy nipple/areola combination can look like a big mosquito bite and show through your clothes. Puffy nipples or areolas are often the first sign of breast development that other people can see—making you feel very self-? conscious—even before there is any breast tissue growth underneath.

Breast Gland Tissue

Starts Growing

After your nipples and areolas get bigger, the breast buds underneath blossom further into the breast glands—the part that makes and drains milk.

The lobules and the milk ducts start up where they left off when you were born, branching again and again, like a tree in full bloom or a hand with many fingers. As this process progresses, the breast tissue gets bigger and thicker. Fat fills in around the lobules and ducts and provides a protective cushion for these delicate and sensitive structures.

The breasts grow straight out before they grow from side to side. That’s why they may look cone-?shaped and pointy in the beginning. But over time they will get rounder and fuller.

While the nipples and areolas stay puffy, they can look like a little hill on top of a big mountain (breast tissue). Eventually the areolas flatten and the nipples in the middle get bigger and stick out more.

Later, the nipples and areolas stay about the same size while the breast underneath continues to get larger and rounder.

Some girls have nipples that point inward like a belly button that goes in (an “innie”) rather than one that sticks out (an “outie”). Even though there is a medical term for this—inverted nipples—it’s totally normal. (Chapter 5 has more information on all kinds of nipple variations.)

Nipple and areola size and color vary a lot from girl to girl; no two nipple-areola sets are the same. Big breasts with a small nipple-areola set, small breasts with a big set, or medium breasts with “mixed doubles” (large areolas and small nipples) are all completely normal. Nipples and areolas also come in different colors: light or dark shades of pink, beige, purple, brown, and black. A mixture of these colors might blend into one shade, or these colors may be pieced together like a mosaic or a patchwork quilt. You can also get freckles or other kinds of skin spots on your nipples and areolas. And sometimes the nipples are a slightly different color than your areolas.

Finishing Touches: These Breast Changes

Are Going to Take Some Time

On average, it takes four years for girls to complete most of their breast growth. Sometimes it happens faster—over a few years—and sometimes it happens slower, such as over eight years.

Breast growth is not always continuous. Don’t be surprised or worried if your breasts start growing, stop, start again, stop, and then finish. Plus the speed of your breast growth can change: sometimes fast, some?times slow. One side might grow faster than the other side.

Over time, your breasts will get rounder just like the rest of your body, including your hips and rear end. Breasts reach their full size and shape by the time you’re twenty-?five, so you can’t be sure that your breasts are full-?grown until then. But it’s really not until pregnancy that your breasts completely mature and learn how to make and drain milk for breast-feeding.

Any Questions?

Why do some boys get breasts?

You may have noticed that some boys grow breasts too. The medical term for enlarged breasts in males is gynecomastia—which means “woman-like breasts.” Another not-so-polite word you might have heard to describe a boy’s breasts is moobs (short for “man boobs”).

Believe it or not, most boys (about two-thirds) get some breast enlargement during puberty. Boys may even grow breasts earlier and bigger than girls their own age. Usually this breast growth goes away within a few years.

Really big boy breasts that look like a woman’s breasts are uncommon. But either way, it’s a very embarrassing problem, particularly during the summer when boys are expected to go shirtless at the beach.

I noticed my friend Jack has breasts. Why? And how should I deal with it?

As funny-looking as boy breasts might appear, you have to stop yourself from making fun of someone in this situation. The hurt feelings can go deep down and leave emotional scars that can last many years. Take a second to put yourself in his shoes; you wouldn’t want to be made fun of.

Being overweight is often the most common cause of breast enlargement in boys. Hormones are another common cause—these are special protein “messengers” in the blood that tell the breasts to grow. The much higher level of female hormones and the much lower levels of male hormones in girls are the main reasons why girls grow breasts and boys usually don’t.

Everyone has a balance of both boy and girl hormones. In boys, there are more boy hormones than girl hormones. In girls, there are more girl hormones than boy hormones. In some boys, the girl hormones cause breasts to form. In some girls, the boy hormones can limit breast growth. Over the years, as the balance of hormones changes, breast growth can also change.

Certain products contain substances that can act like hormones. For example, lavender oil and tea tree oils have been associated with breast enlargement in boys before puberty (these oils are present in some soaps, moisturizers, shampoos, and hair care products).

Some boys are born with an inherited genetic condition that can result in enlarged breasts.

Certain medicines can make breasts bigger—but most of these medicines are taken by adult men (not boys). About half of adult men develop breast enlargement over time. All the things that make breasts bigger in boys can also happen to men. Drinking too much alcohol is another cause in men.

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Excerpted from Taking Care of Your Girls: A Breast Health Guide for Girls, Teens and In-Betweens by Marisa C. Weiss, Isabel Friedman
All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.