title: 17β-Estradiol and Gonadotropin Levels for the Diagnosis of the Benign Form of Breast Development in Girls Aged up to 4 Years in Real-Life Clinical Practice.
abstract: BACKGROUND
  Early onset of breast development in a young girl is usually a benign and isolated prepubertal condition, i.e., premature thelarche (PT), but can sometimes be progressive and the first sign of pubertal precocity (PP). Serum 17β-estradiol (17β-E2) level is a possible marker to differentiate between benign and pathological forms of breast development. We defined an upper serum 17β-E2 level for benign, "classic" PT for girls aged 9-48 months.
  
  
  METHODS
  Serum 17β-E2 was analysed with a highly sensitive extraction radioimmunoassay (RIA). Gonadotropins, Tanner breast stage, growth, other investigations, and clinical outcome were assessed in 125 girls with breast development, in a population-based study in West Sweden.
  
  
  RESULTS
  A total of 125 of 128 girls had a benign form of breast development with a mean serum 17β-E2 level of 15.2 pmol/L and a mean + 2 SD of 31 pmol/L, which was regarded as the upper limit for benign PT; 3 girls with PP had 17β-E2 levels above 70 pmol/L.
  
  
  CONCLUSIONS
  This is the first study to define an upper serum 17β-E2 level associated with benign PT. Girls aged 9-48 months with PT and Tanner breast stage 2 have 17β-E2 levels below 32 pmol/L using extraction RIA. LH below the detection limit (0.1 IU/L) and measurable FSH support benign PT.
authors.affiliation: Department of Pediatrics, Gothenburg Pediatric Growth Research Center, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden.|Department of Pediatrics, NU Hospital Group, Trollhättan, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Österbrand
authors.affiliation: Department of Pediatrics, Gothenburg Pediatric Growth Research Center, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden.|Department of Pediatrics, NU Hospital Group, Trollhättan, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Fors
authors.affiliation: Department of Pediatrics, Gothenburg Pediatric Growth Research Center, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Allvin
authors.affiliation: Department of Pediatrics, Gothenburg Pediatric Growth Research Center, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden.
authors.forename: Ensio
authors.initials: E
authors.lastname: Norjavaara
mesh_terms: D001940:Breast / Q000254:growth & development*; D002675:Child, Preschool; D004958:Estradiol / Q000097:blood*; D005260:Female; D006062:Gonadotropins / Q000097:blood*; D006801:Humans; D007223:Infant; D011629:Puberty, Precocious / Q000097:blood* / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology
chemical_list: D006062:Gonadotropins; D004958:Estradiol
keywords: 17β-Estradiol; Gonadotropins; Growth acceleration; Premature thelarche