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Premature Thelarche

more about Premature Thelarche

  • In this condition, there is early appearance of breast development in a female, before the normal age.  Usually, this early enlargement of the breast or breasts occurs between ages 1 and 3 years.  Normally, there would be no breast development before age 8.
  • In some girls, enlarged breasts are present at birth, and the condition persists.
  • In premature thelarche, there are no other signs of early puberty, except the breast development.
  • The breast development is limited, and the little girl does not form an adult-size female breast until puberty.  The enlarged breast or breasts might regress spontaneously.
  • Normal puberty does not occur before the age of 8 years.

  • In this condition, there is early breast development between the ages of 1 and 3 years.

  • Unknown
  • In rare cases, exposure to the mother's estrogen tablets or mother's estrogen cream is the cause.

  • Physical examination shows a child, 1 to 3 years of age, with an enlarged breast or both breasts enlarged.  There are no other signs of puberty.
  • There is no acne.
  • There is no increased size of the genitals.
  • There is no vaginal discharge or vaginal bleeding.
  • There is no enlargement of the uterus.
  • There is no pubic hair or axillary hair or axillary odor.
  • Hormone levels of adrenal hormones and sex hormones are not elevated.
  • There are no abdominal masses or pelvic masses.

  • No treatment is necessary, and the breasts will not enlarge to the size of an adult's before puberty.
  • The excess breast tissue should not be removed surgically because that would lead to a deformity of the adult breast.
  • Close medical followup of the girls with this condition is needed, every 6 months, because a small percentage of these girls will additionally have precocious puberty (early puberty) before the age of 8 years, and precocious puberty is abnormal.
  • No laboratory test is available to predict which girls with premature thelarche will go on to have precocious puberty.
  • Another reason that close medical followup is needed every 6 months is that rarely this might really be a case of (a) a Brain Tumor or (b) an abdominal or adrenal or pelvic tumor that is releasing hormones, or (c) a defect in the adrenal gland present from birth, called congenital adrenal hyperplasia.
  • These 6 signs could be worrisome, in premature thelarche:
    1. Early appearance of acne
    2. Early appearance of a deepened voice
    3. advanced bone age on an x-ray of the wrist, showing that the bones are more like a teenager's bones
    4. High levels of adrenal hormones or sex hormones, higher-than-normal-for-age
    5. Early appearance of the growth spurt (that normally occurs in the teenage years)
    6. Enlarging clitoris or enlarging sex organs
  • If the physician suspects that precocious puberty or a tumor is causing the release of hormones, he would perform another detailed physical examination and measure the amount of various hormones in the blood, and perform a CAT scan or MRI scan of the brain, the abdomen, the adrenal glands, and possibly the pelvis to see if a tumor is present.  An ultrasound might also be done.

  • There are no complications from premature thelarche alone.

  • Your physician should examine your child if early enlargement of the breast or breasts occurs, or if any other sign occurs that might indicate early puberty (early acne, early enlargement of the genitals, early appearance of pubic hair, axillary hair, axillary odor).  Showing these changes to your physician is especially necessary if the physical changes occur before the age of 8 years.

  • In the newborn boy or girl, the breasts may be slightly enlarged due to the normal hormones of pregnancy.  The breasts are then called "breast buds."  This usually resolves in early infancy.

more about Premature Thelarche

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