Healthy Breast

Healthy, Normal Breast

a. What is a breast?

The breast is an extension of the skin and a gland that secretes milk (like the sebaceous gland and sweat gland). In adolescent girls, the beginning of nipple development is the first sexual development detected by inspection.

Sexual Development During Puberty:
Five major changes are defined for boys and girls during puberty (Tanner Stages). In both sexes, sexual development generally follows a specific sequence. Two fundamental physical changes are observed in girls:

• Breast development
• Pubic hair growth

The first sign of sexual development in girls is breast enlargement, followed by a growth spurt. Shortly thereafter, hair growth occurs in the pubic area and under the arms. While breast development (thelarche) begins, menarche occurs approximately two years later. In recent years, it has been reported that the age of thelarche in young girls has shifted to earlier ages. Breast development begins on average at 9-8 years of age. It is normal for it to begin between the ages of 8 and 13 on average. However, if it begins before the age of 8, it is called “Early Breast Development,” and if it develops after the age of 13, it is called “Delayed Breast Development.” In both cases, a doctor should be consulted to investigate whether there is another disease causing early or late onset, and if so, the necessary treatment should be started.

Breast development and pubic hair growth are assessed using Tanner Stages (Figure).
Stages of breast development in girls:
Stage 1: Breast development has not yet begun.
Stage 2: Budding begins under the areola.
Stage 3: The areola and breast tissue grow.
Stage 4: The areola and nipple form a secondary protrusion above the breast tissue.
Stage 5: The breast tissue is larger. The areola retracts. It joins the breast tissue. Only the nipple protrudes. (Source: Kınık E. Physical growth and sexual development in adolescence. Katkı Pediatri journal. Vol. 21, no. 6, 726. Ankara. 2000.)