Sex

Benign Premature Thelarche

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Benign Premature Thelarche, Premature Thelarche

  • See Also
  1. Precocious Puberty
  2. Precocious Puberty Causes
  3. Benign Premature Adrenarche
  4. Sexual Development
  5. Male Tanner Stage
  6. Female Tanner Stage
  • 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 of glandular Breast tissue (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. See Precocious Puberty Causes
  2. 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. Indications for pediatric endocrinology referral (based on serial exams every 3-6 months)
    1. Progressive Breast development
    2. Associated other signs of pubertal development
    3. Increased Growth Velocity
    4. Advanced Bone Age
  3. Do not biopsy Breast
    1. Biopsy results in partial Mastectomy
    2. Further Breast development abnormal post-biopsy
  • Course
  1. Spontaneous resolution
  • References
  1. Brown (2025) Am Fam Physician 112(5): 513-21 [PubMed]
  2. Klein (2017) Am Fam Physician 96(9): 590-99 [PubMed]