Pediatric Premature Thelarche

What is Pediatric Premature Thelarche?

Puberty typically occurs between the ages of 10 and 14 for girls. If a child has premature thelarche, changes occurs prior to age 8. Premature thelarche is not associated with other signs of puberty such as pubic hair or periods. Most are diagnosed before the age of two, but in rare cases, the condition is diagnosed between the age of 6 and 8.

What are the signs and symptoms of Pediatric Premature Thelarche?

The main symptoms of premature thelarche is enlarged breast tissue anytime from birth to eight years old. It can be associated with premature puberty.

Typically, the breast tissue is small (1-inch or less across). It usually occurs on both sides (bilateral), but it can occur on only one side (unilateral). This disorder usually goes away on its own, but it can take a few years to fully disappear.

How is Pediatric Premature Thelarche diagnosed?

Your daughter’s doctor will first ask questions about when the breast growth started. The doctor will then perform a physical exam, which may include checking for any pubic hair and other signs of possible early puberty.  Your doctor will order blood hormone levels and check and x-ray of the hand and wrist (a Bone Age) to determine if this is a normal variant or if treatment for precocious puberty is warranted.

This can be differentiated from premature puberty as premature thelarche involves:

• Isolated breast development that is typically small and either unilateral or bilateral – Typically not developing beyond Tanner stage 3
• No other secondary sexual characteristics or signs of puberty
• A normal growth velocity for age 
• A normal or near-normal bone age

How is Pediatric Premature Thelarche treated?

If your daughter is diagnosed with premature thelarche, there is usually no specific treatment as this is a benign condition in children. Your doctor may reassure you that your daughter’s breast growth may regress spontaneously or at least not progress, and that puberty may follow normally as you child gets older. Your doctor may also choose to re-examine your daughter in 6 months to monitor for any progression of her symptoms and make sure that she is growing at a normal rate.