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the start of breast development in a woman at the beginning of puberty

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/08/17 22:04:00」(JST)

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Thelarche ( /θɨˈlɑrkiː/) is the onset of secondary (postnatal) breast development,^[1] usually occurring at the beginning of puberty in girls. Its etymology is from Greek θηλή [tʰelḗ], “nipple” and ἀρχή [arkʰḗ], “beginning, onset”. Thelarche is usually noticed as a firm, tender lump directly under the centre of the nipple (papilla and areola). Thelarche is also referred to as a "breast bud", or more formally as Tanner stage 2 breast development (Tanner stage 1 being the entirely undeveloped prepubertal state). Thelarche may occur on one side first, or both sides simultaneously.

Thelarche is the first physical change of puberty in about 60% of girls, usually after 8 years. It is a result of rising levels of estradiol. It is typical for a woman's breasts to be unequal in size, particularly while the breasts are developing. Statistically it is slightly more common for the left breast to be the larger.^[2] In rare cases, the breasts may be significantly different in size, or one breast may fail to develop entirely.

Although breast development can occur as a part of normal male puberty, it is termed gynecomastia, and the term "thelarche" is not used with reference to male breast development.

When thelarche occurs at an unusually early age, it may be the first manifestation of precocious puberty. If no other changes of puberty or sex hormone effects occur, it is referred to as isolated premature thelarche, and needs no treatment.

As with menarche, many young girls are not prepared for breast development, or have been trained to feel ashamed of breasts through active instruction or modelling. Some possible consequences of such neglect are negative body image, appearance anxiety, lowered self-esteem, and delayed diagnosis of breast tumors. ^[3] The introduction of research-based educational materials on breast development for primary and middle schools has been proposed to promote breast health by reducing shame. ^[4]

Isolated premature thelarche

Premature thelarche is a benign, self-limiting condition which is characterised by breast development with no other signs of sexual maturation.

There may well be two types of premature thelarche.

The classical type commences during the first year of life and tends to resolve by the age of 2.

There is a second form of premature thelarche, of which the age of onset is over 2 years of age and this tends to be more persistent and with a higher incidence of uterine bleeding for the child.

References

Isolated Premature Thelarche

^ Dictionary.com > thelarche Citing:
- The American Heritage® Stedman's Medical Dictionary
Copyright © 2002, 2001, 1995
- Merriam-Webster's Medical Dictionary, © 2007
^ C.W. Loughry, et al. (1989). "Breast volume measurement of 598 women using biostereometric analysis". Annals of Plastic Surgery 22 (5): 380–385. doi:10.1097/00000637-198905000-00002. PMID 2729845.
^ “Menarche: the Transition from Girl to Woman,” Sharon Golub (ed.) (Lexington Books, Toronto, 1983).
^ http://sexhysteria.wordpress.com/2011/09/01/breast-shame-tradition-deception-and-the-money-trail/

UpToDate Contents

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1. 小児および思春期における乳房疾患の概要 overview of breast disorders in children and adolescents
2. 乳房の発達および形態 breast development and morphology
3. 小児および思春期における乳房腫瘤の概要 overview of breast masses in children and adolescents
4. 思春期早発症の定義、原因、および評価 definition etiology and evaluation of precocious puberty
5. 正常思春期 normal puberty

English Journal

The prevalence and risk factors of premature thelarche and pubarche in 4- to 8-year-old girls.

Atay Z, Turan S, Guran T, Furman A, Bereket A.Source?Department of Pediatric Endocrinology, School of Medicine, Marmara University, Istanbul, Turkey ?Institute of Environmental Sciences, Bogazici University, Istanbul, Turkey.
Acta paediatrica (Oslo, Norway : 1992).Acta Paediatr.2011 Aug 20. doi: 10.1111/j.1651-2227.2011.02444.x. [Epub ahead of print]
Aim:? To assess the prevalence of premature thelarche (PT) and pubarche in healthy 4- to 8-year-old girls and to investigate factors associated with early pubertal development. Method:? Eight hundred and twenty girls were examined by two paediatric endocrinologists to determine Tanner staging. T
PMID 21854448

Pubertal development in daughters of women with pre-eclampsia.

Ogland B, Nilsen ST, Forman MR, Vatten LJ.SourceDepartment of Pediatrics, Stavanger University Hospital, Stavanger, Norway. bogland@online.no
Archives of disease in childhood.Arch Dis Child.2011 Aug;96(8):740-3. Epub 2010 Oct 7.
OBJECTIVE: To compare clinical signs of puberty onset in daughters of pre-eclampsia and normotensive pregnancies.DESIGN: Population based follow-up study.METHODS: In a cohort of 120 daughters of pre-eclampsia pregnancies and 203 daughters of pregnancies without pre-eclampsia, pubic hair growth and b
PMID 20930013

Japanese Journal

Mayer-Rokitansky-Kuster-Hauser syndrome presenting as premature thelarche in a young child

ATABEK MEHMET EMRE,PIRGON OZGUR,SERT AHMET
Pediatrics international : official journal of the Japan Pediatric Society 49(4), 533-535, 2007-08-01
NAID 10019815031