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. 2013 Dec;132(6):1019-27.
doi: 10.1542/peds.2012-3773. Epub 2013 Nov 4.

Onset of breast development in a longitudinal cohort

Frank M Biro  1 , Louise C Greenspan, Maida P Galvez, Susan M Pinney, Susan Teitelbaum, Gayle C Windham, Julianna Deardorff, Robert L Herrick, Paul A Succop, Robert A Hiatt, Lawrence H Kushi, Mary S Wolff
Affiliations

Onset of breast development in a longitudinal cohort

Frank M Biro et al. Pediatrics. 2013 Dec.

Abstract

Background and objectives: There is growing evidence of pubertal maturation occurring at earlier ages, with many studies based on cross-sectional observations. This study examined age at onset of breast development (thelarche), and the impact of BMI and race/ethnicity, in the 3 puberty study sites of the Breast Cancer and the Environment Research Program, a prospective cohort of >1200 girls.

Methods: Girls, 6 to 8 years at enrollment, were followed longitudinally at regular intervals from 2004 to 2011 in 3 geographic areas: the San Francisco Bay Area, Greater Cincinnati, and New York City. Sexual maturity assessment using Tanner staging was conducted by using standardized observation and palpation methods by trained and certified staff. Kaplan-Meier analyses were used to describe age at onset of breast maturation by covariates.

Results: The age at onset of breast stage 2 varied by race/ethnicity, BMI at baseline, and site. Median age at onset of breast stage 2 was 8.8, 9.3, 9.7, and 9.7 years for African American, Hispanic, white non-Hispanic, and Asian participants, respectively. Girls with greater BMI reached breast stage 2 at younger ages. Age-specific and standardized prevalence of breast maturation was contrasted to observations in 2 large cross-sectional studies conducted 10 to 20 years earlier (Pediatric Research in Office Settings and National Health and Nutrition Examination Survey III) and found to have occurred earlier among white, non-Hispanic, but not African American girls.

Conclusions: We observed the onset of thelarche at younger ages than previously documented, with important differences associated with race/ethnicity and BMI, confirming and extending patterns seen previously. These findings are consistent with temporal changes in BMI.

Keywords: breast development; girls; obesity; puberty.

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Figures

FIGURE 1
FIGURE 1
Comparing the cumulative prevalence of Breast Stage 2+ for non-Hispanic white participants between the BCERP Puberty Study and PROS.
FIGURE 2
FIGURE 2
Comparing cumulative prevalence of Breast Stage 2+ for non-Hispanic black participants between the BCERP Puberty Study and PROS.
See this image and copyright information in PMC

Comment in

  • The enigmatic pursuit of puberty in girls.
    Herman-Giddens ME. Herman-Giddens ME. Pediatrics. 2013 Dec;132(6):1125-6. doi: 10.1542/peds.2013-3058. Epub 2013 Nov 4. Pediatrics. 2013. PMID: 24190683 No abstract available.

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