SEX MATURITY IN GIRLS: BREAST

Stage 1: Preadolescent. Elevation of nipple only
Stage 2: Breast bud stage. Elevation of breast and nipple as a small mound; enlargement of areolar diameter
Stage 3: Further enlargement and elevation of breast and areola, with no separation of their contours
Stage 4: Projection of areola and nipple to form a secondary mound above the level of breast
Stage 5: Mature stage; projection of nipple only. Areola has receded to general contour of the breast (although in some normal individuals the areola continues to form a secondary mound)

Simultaneously, pubic hair appear. These two developmental changes – in breasts and pubic hair –shown below are useful- in assessing growth and maturation, although they do not necessarily proceed synchronously in any given person. The sequence from SMR 2 to SMR 5 takes about 3 years on the average, with a range of 1.5 to 6 years. Axillary hair usually appears about 2 years after pubic hair.

Menarche ordinarily occurs when a girl is in breast stage 3 or 4. By the time of menarche a girl has characteristically reached the peak of her adolescent growth spurt. Although she may continue to grow somewhat, her rate of growth has begun to taper off.