Naked teen with breast buds

Women who have breast hyperplasia have some breast tissue that does not mature, so the breasts hardly develop at all. There are different causes but one specific condition that results in very little breast development is Poland’s syndrome. Girls born with this have no breast buds, the small area of tissue usually present just under the nipple from which the breast grows during puberty.

14% of the girls presented breast buds and 43% had excess weight (BMI z-score > 1, World Health Organization 2007). Self-assessment showed low concordance with the evaluator (K < 0.1) and girls with excess weight over-diagnosed more than girls of normal weight (44% vs. 24%, p-value < 0.05). Instead, mothers showed good concordance with the evaluator (K = 0.7, 95% confidence interval (CI) = 0.6-0.9), even in overweight girls and/or in mothers with low education (K = 0.7, 95% CI = 0.6-0.8).

The very first step is to remember that it’s perfectly normal. Sometimes breast buds develop on one side before the other; sometimes a bud seems to appear and then disappear; some breast buds are super tender and sore. And if all of this isn’t inconsistent enough, sometimes nine-year-olds don’t have any breast development — some breasts don’t begin budding until 12 or even 13. If you have any worries about this or any other newly appearing feature on your kid’s body, speak with your healthcare provider.

From a healthcare professional: I have a six year-old girl with breast buds. How much of an evaluation is necessary?

Sensitivity (percentage of girls or mothers who correctly diagnosed the presence of breast buds) and specificity (percentage of girls or mothers who correctly diagnosed Tanner breast stage 1) of breast bud detection was calculated using the trained personnel assessment as the reference. Over-diagnosis of breast bud was estimated as the percentage of the girls classified as Tanner stage 1 by the trained personnel who were evaluated as Tanner stage 2 by the girl or her mother. These analyses were repeated, stratifying by the girl’s nutritional status and mother’s education; statistical differences among groups were evaluated using Chi-squared test and were considered significant if p-value <0.05. All analyses were performed with STATA version 10.0 [].

Breast development looks different for all people, but it generally happens in several stages. In the earliest stages, the nipple becomes slightly elevated. Then, breast buds develop to resemble nickel-sized bumps, with both the nipple and breast becoming more elevated and the areola darkening in color.