Rosh Pediatrics Practice Exam

A 13-year-old girl has subareolar breast buds but no menarche. Which Tanner stage is this and is it considered delayed?

1. Tanner stage 1, delayed

2. Tanner stage 2, delayed

3. Tanner stage 2, not delayed

4. Tanner stage 3, not delayed

The correct answer is: Tanner stage 2, not delayed

The presence of subareolar breast buds in a 13-year-old girl indicates that she is entering the second stage of breast development according to the Tanner stages. Tanner stage 2 is characterized by the beginning of breast development, which includes the formation of small breast buds. At this stage, it is common for girls to not yet have started menstruating, as menarche typically occurs later, often around Tanner stage 3 or 4. Determining whether development is considered delayed involves looking at the expected timeline for Tanner stages and the onset of menarche. The average age for onset of breast development is around 10 to 11 years, with menarche typically occurring about 2 to 3 years after breast development starts. Since this girl is 13 years old and has breast buds but no menarche, her development aligns with Tanner stage 2, and the absence of menstruation at this stage is still within the typical range. Therefore, the assessment of Tanner stage 2 is accurate, and since she is only just beginning breast development, it is not considered delayed in the context of typical adolescent development timelines.