The assessment of premature thelarche.

Background: Premature thelarche (PT) is defined as early breast development without other signs of pubertal maturation. It is frequently considered to be a normal variant of pubertal growth in girls. When premature thelarche presents under the age of two years, most infants will have spontaneous remission.

Objective: Progression to precocious puberty (PP) can be seen in infants with PT, especially when breast development commences after the age of five years. With consequences on bone maturation and final height, it is imperative that general practitioners (GPs) confidently differentiate isolated benign PT from that which might progress to PP.

Discussion: This article emphasises the importance of simple baseline investigations, referral red flags and judicious follow-up to allay parental anxiety or expedite treatment of PT for those children who need it.