PREMATURE THELARCHAE

Dr. Bhupendra Gupta
B.H.M.S.

What is premature thelarche?

 Thelarche means "the beginning of breast development." Therefore, if a girl begins 

to show breast enlargement at an early age (anywhere from birth to six years), it 
is called "premature thelarche."

PREMATURE BREAST, NORMALLY OCCUR DURING THE AGE BETWEEN 3-6 YRS. 

Technically, most cases of early breast enlargement are harmless, and do not progress 
significantly. They are not the beginning of (continued) breast development. They 
also are not usually associated with the development of the other physical signs 
of puberty, e.g., acne, pubic hair, periods, or rapid growth. Therefore, a better 
term for this condition is infantile, or early, "gynecomastia," which only signifies 
that one or both breasts are enlarged.

What causes premature thelarche?

 Studies of girls with early breast enlargement have not shown elevated blood levels 

of estrogen or any other abnormality. Occasionally, an ovarian cyst (or cysts) may 
be seen on a pelvic ultrasound, but this condition also may occur in girls without 
breast enlargement; therefore, it is not clear if the cyst(s) are secreting enough 
estrogen to cause the breast enlargement. Some physicians believe that the girls 
are just temporarily more sensitive to their normal blood levels of estrogen.

Who gets premature thelarche?

 There is not one identifiable group of girls who develops early breast enlargement. 

 How does premature thelarche cause disease?

Premature thelarche is not a disease; instead, it is a normal finding in some young 

girls or female infants. If there are other signs of puberty, then a physician should 
evaluate the child for the causes of early puberty. it is a concern if a male infant or a young boy shows breast enlargement.

What are the common findings?

 The common finding is the enlargement of one or both breasts. In simple premature 

thelarche, there are no other signs of pubertal development, and the child is growing 
at a normal-not an increased-rate

How is premature thelarche diagnosed?

 Most commonly, premature thelarche is diagnosed in a female infant or a girl up 

to three years of age. Occasionally, a girl from three to six years of age will 
show an enlargement of one or both breasts. However, after age six, the beginning 
of breast development is actually the beginning of puberty; however, it is a very 
slow form of development. In addition, girls with early breast development usually 
do not have early periods.

Typically, the girl has no other signs of puberty, and is growing at a normal, pre-pubertal 
growth rate, i.e., about two inches a year. Laboratory studies are not usually helpful, 
since they show low (pre-pubertal) concentrations of estrogen or other hormones 
that stimulate pubertal development. An x-ray of the hand shows a picture that is 
normal for the girl's age, and not that of an older girl.

How is premature thelarche treated?

 Treatment for early breast development is not necessary; however, the physician 

and the parents may want to monitor any changes in the girl's breast size.

What are the complications?

 Usually, there are no complications associated with early breast development. Since 

there is a very small chance that the girl is actually starting puberty, it is recommended 
that both the physician and the parents monitor her.

How is premature thelarche prevented?

 Premature Thelarche cannot be prevented. Parents should be sensitive to their children's 

concerns and encourage communication so as to alleviate anxiety or fears.