BREAST CONTACT THERMOGRAPHY IN DIFFERENTIAL DIAGNOSIS OF PREMATURE THELARCHE AND PRECOCIOUS PUBERTY

Abstract

In order to contribute to the differential diagnosis between idiopathic Premature Thelarche (PT)and true Precocious Puberty (PP) we performed Breast Contact Thermography (BCT, cholesteric liquid crystal plates) in 13 girls with PT and 12 with PP (previously diagnosed) and in 105 control girls (Tanner's 81-5). We evaluated the 4 principal components (fundus, vascularization, nipple and periareolar heat changes). Arbitrary gradual scores (0,1,2…) were attributed to the maturative signs. A Thermographic Index (TI= sum of the 4 scores of a single breast) and the higher TI (hTI = between the 2 breasts of single girls) were calculated.Results: in controls, single scores, TI and hTI had a positive correlation (r, p<0.001) with B stages. In PT, all signs of vascularization were always (100%) absent, while in PP they were always present, although in some cases monolaterally. The TI of PT was not different from B1 girls and significantly lower (p<0.001) than PP girls and B>1 controls. The hTI ranged from 0 to 3 in PT, from 4 to 13 in PP girls.We conclude that low hTI (≤ 3)and no signs of vascularization indicate PT, while vascular hyperthermia and hTI ≥ 4 indicate PP. We emphasize the useful diagnostic aid of the noninvasive imaging technique of BCT in evaluating the pathophysiology of pubertal breast development.