Sex

Benign Premature Thelarche

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Benign Premature Thelarche, Premature Thelarche

  • Epidemiology
  1. Onset as early as age 18 months
  • Pathophysiology
  1. Benign self-limited cause of Precocious Puberty
  • Exam
  1. Examine with girl lying down
  2. Identify if Breast glandular tissue beneath areola
  • Signs
  1. Early Breast development (not to mature Breast contour)
  2. Isolated glandular Breast tissue on palpation
  3. No other signs of Puberty
  4. Normal prepubertal growth rate
  • Differential Diagnosis
  1. Lipomastia
    1. Fatty Breast tissue in obese girls
  • Imaging
  1. Bone Age consistent Chronological age
  2. Ovarian Ultrasound normal
  • Labs
  1. Serum Gonadotropin levels normal
  2. Serum Estradiol normal
  • Management
  1. Reassurance
  2. Do not biopsy Breast
    1. Biopsy results in partial Mastectomy
    2. Further Breast development abnormal post-biopsy
  • Course
  1. Spontaneous resolution