Should prepubertal children be treated?

Patient's question:

Child
Patient Age: 11
Detailed Medical Condition and Purpose of Consultation: Half a month ago, the child mentioned some pain in the nipple and felt slightly hard when touched. The hospital examination indicated it was due to development, but it was more than a year ahead of the age-matched peers. It was recommended to engage in more exercise and reduce the intake of hormone-containing foods, such as fried foods, KFC, and similar items.
Duration and Onset of Current Illness: Half a month
Current General Condition: No discomfort.
Medical History: No history
Previous Diagnoses, Treatments, and Outcomes: First discovery

Doctor's answer:

1. Isolated premature thelarche
This refers to a subset of central precocious puberty (PICPP), where FSH levels significantly increase after GnRH stimulation (they also rise in normal prepubertal girls), but LH levels do not increase markedly (most cases), and the FSH/LH ratio is greater than 1. However, it is important to note that PICPP can transform into CPP without any clinical signs. Therefore, regular follow-up is necessary after diagnosing PICPP, especially for cases with recurrent breast enlargement or persistent enlargement, and repeat stimulation tests may be required if needed.
2. CPP resulting from non-central precocious puberty
Such as congenital adrenal hyperplasia, McCune-Albright syndrome, etc. Close monitoring for CPP development must be maintained during the treatment of the primary disease.
3. Precocious puberty associated with congenital hypothyroidism
This is a special type of precocious puberty. In early-stage patients, basal LH levels are elevated, but they do not rise after GnRH stimulation. It takes a prolonged course before it fully converts into true CPP. Short stature is a key characteristic.