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Breast disorders in children and adolescents
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Nirupama K. De Silva, Monica Henning
Thelarche, the onset of pubertal breast development, is hormonally mediated. Thelarche normally occurs between the ages of 8 and 13, with an average age of 10.3 years,7 but the timing is influenced by race and can be affected by other outside influences. Research suggests that at all ages, normal thelarche is more advanced in African American girls than white girls. In a landmark study by Herman-Giddens, they report that approximately 15% of white girls have thelarche between the ages of 8 and 9, whereas 48% of African American children experience thelarche at this age. In the study, the mean age of onset of breast development for African American girls was 8.9 years, while the average age of thelarche in white females was approximately 10 years of age.8 Other risk factors associated with earlier puberty include adiposity and Mexican American ethnicity.9 The Breast Cancer and the Environment Research Program, a prospective cohort of more than 1200 girls, observed the onset of thelarche at younger ages (ages 8.8 for African American girls and 9.3 for Caucasian females) than noted previously, and confirmed differences associated with race/ethnicity and increased adiposity.10
Single best answers: gynaecology
Published in Janice Rymer, Norman Smith, Obstetrics and Gynaecology for Finals, DRCOG and MRCOG, 2017
Thelarche is the first sexual change to occur, with development of the breast. Then adrenarche – pubic and then axillary hair growth, which are dependent on adrenal development. The final manifestation of sexual maturity is the onset of menstruation – menarche.
The Child With A Pubertal Development Disorder
Published in Michael B O’Neill, Michelle Mary Mcevoy, Alf J Nicholson, Terence Stephenson, Stephanie Ryan, Diagnosing and Treating Common Problems in Paediatrics, 2017
Michael B O’Neill, Michelle Mary Mcevoy, Alf J Nicholson, Terence Stephenson, Stephanie Ryan
Premature thelarche is a benign entity. The breast size may fluctuate but will never exceed stage 3 development. Children will be unaware of this development and parents can be reassured that the child will progress to puberty at a normal age. Blood tests will be unhelpful to explain the breast enlargement and suggestions that premature thelarche is related to increased sensitivity to oestrogens is speculative.
Deep phenotyping of pubertal development in Norwegian children: the Bergen Growth Study 2
Published in Annals of Human Biology, 2023
Petur B. Juliusson, Ingvild S. Bruserud, Ninnie Helen Bakken Oehme, Andre Madsen, Ingvild H. Forthun, Melissa Balthasar, Karen Rosendahl, Kristin Viste, Astanand Jugessur, Lawrence M. Schell, Robert Bjerknes, Mathieu Roelants
Age at menarche has decreased significantly since the nineteenth century (Parent et al., 2015). More recent data from Denmark and the United States indicate that the onset of puberty is continuing to decline (Aksglaede et al., 2009; Eckert-Lind et al., 2020; Herman-Giddens et al., 1997, 2001). Herman-Giddens et al. (1997) reported an earlier onset of breast development (thelarche) in girls, especially among Afro-Americans and Hispanics in the US. Aksglaede et al. (2009) compared pubertal development between 1991 and 2006 in Copenhagen and found similar evidence of early pubertal development, especially thelarche, that could not be explained by changes in hormonal levels or BMI. Trends towards accelerated maturation have also been reported in boys, but the magnitude of these changes appears to be less than in girls (Herman-Giddens et al., 2001).
Early menarche in visually impaired girls: evidence and hypothesis of light-dark cycle disruption and blindness effect on puberty onset
Published in Chronobiology International, 2022
Jorge A. Barrero, Ismena Mockus
Over the last decades, the age at puberty onset among women has progressively decreased (Aksglaede et al. 2009; Lee et al. 2019). Within the different causes underlying this phenomenon, endocrine-disrupting chemicals and environmental stimuli have drawn particular attention in response to the studies that link them with earlier thelarche and menarche (Colón et al. 2000; Lucaccioni et al. 2020; Vasiliu 2004). Consistent with this idea, conveyed stimuli from the environment have been shown to gradually influence sexual maturation (Fisher and Eugster 2014; Yermachenko and Dvornyk 2014). While alterations in HPG axis function have been identified in subjects with no light perception (Bellastella et al. 2014), a large number of the studies reported so far overlook the role of the light stimulation in sexual maturity onset. To this end, the assessment of the age at menarche in blind girls turns out to be a scenario that enables the study of sexual development in subjects with light-sensing impairment (Aubin et al. 2017; Lewy 2007), and thus, allows one to approach the effect of light-dark cycle on the onset of puberty in humans.
Mammary Fibrocystic Change in a Pre-Pubertal child- A Case Report with a Histopathological Perspective
Published in Fetal and Pediatric Pathology, 2021
Smita Singh, Kavita Gaur, Archana Puri
Fibrocystic disease in a two year old child is novel. In a study done by Bock et al on breast lesions in children, 18% showed cystic changes with all cases being described in an age group of 14 to 17 years [9]. An extensive literature search revealed that this has hitherto not been described in a prepubertal child. More importantly, as fibrocystic change is usually synonymous with the “lumpy and bumpy” breast and not a discrete large breast mass, it is usually managed conservatively. In the absence of any obvious systemic hormonal abnormality or any histopathological evidence of inflammatory cells, endocrinal or infectious etiologies seemed unlikely in our case. Premature thelarche was also ruled out as the contralateral breast was clinically normal. The hormonal profile also did not suggest the same.