Cited by 362Hypothalamic control of reproductive hormonesCancer Risks and FactorsAdolescent Sexual and Reproductive Health

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Onset of Breast Development in a Longitudinal Cohort

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Biro, Frank M., Greenspan, Louise C., Galvez, Maida P., Pinney, Susan M., Teitelbaum, Susan, Windham, Gayle C., Deardorff, Julianna, Herrick, Robert L., Succop, Paul A., Hiatt, Robert A., Kushi, Lawrence H., Wolff, Mary S.·2013·PEDIATRICS

DOI 10.1542/peds.2012-3773PMC PMC3838525

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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.

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Authors: Biro, F. M., Greenspan, L. C., Galvez, M. P., Pinney, S. M., Teitelbaum, S., Windham, G. C., Deardorff, J., Herrick, R. L., Succop, P. A., Hiatt, R. A., Kushi, L. H., & Wolff, M. S.
Affiliations: Cincinnati Children's Hospital Medical Center (US)
Kaiser Permanente (US)
Department of Preventive Medicine, and
University of Cincinnati (US)
California Department of Public Health (US)
University of California, Berkeley (US)
University of California, San Francisco (US)
Icahn School of Medicine at Mount Sinai (US)
ORCID: Biro, Frank M.
Galvez, Maida P.
Pinney, Susan M.
Teitelbaum, Susan
Windham, Gayle C.
Deardorff, Julianna
Hiatt, Robert A.
Kushi, Lawrence H.
Wolff, Mary S.
Venue: PEDIATRICS
Publisher: American Academy of Pediatrics (AAP)
Published: 2013-12-01
Volume: 132
Issue: 6
Pages: 1019-1027
ISSN: 0031-4005 (ISSN-L)
1098-4275
DOI: 10.1542/peds.2012-3773
PMC: PMC3838525
OpenAlex: W2113207708
Cited by: 362
References: 45
Citations by year: 2026: 13 · 2025: 20 · 2024: 26 · 2023: 21 · 2022: 48 · 2021: 33 · 2020: 42 · 2019: 30 · 2018: 26 · 2017: 31 · 2016: 32 · 2015: 19 · 2014: 18 · 2013: 2
FWCI: 28.58
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: PEDIATRICS (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: Kaiser Permanente
Michigan State University
University of Cincinnati
National Institutes of Health (5ul1rr026314-03, UL1TR000077)
National Institute of Environmental Health Sciences (P01ES009584, U01ES012800, U01ES019457, U01ES012771, T32-ES 10957, U01ES012770, P30ES006096, U01ES019435, U01ES019453, U01ES012801, U01ES019454, T32ES010957)
National Center for Research Resources (UL1RR024131, UL1RR029887, UL1-RR026314, CSTA-UL1RR026314, CSTA-UL1RR029887)
National Center for Chronic Disease Prevention and Health Promotion
National Center for Advancing Translational Sciences
Topics: Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
Health Sciences › Medicine › Oncology › Cancer Risks and Factors
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Adolescent Sexual and Reproductive Health
Keywords: thelarche, breast development, puberty onset, pubertal timing, body mass index, racial and ethnic differences, African American girls, Hispanic girls, Tanner stages, longitudinal cohort, childhood obesity
MeSH terms: Adolescent, Age Factors, Breast, Child, Female, Humans, Longitudinal Studies, New York City, Ohio, Prospective Studies, Puberty, San Francisco, Body Mass Index, Linear Models, Kaplan-Meier Estimate

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