A 14-year-old female is in for a physical exam. Which finding requires further investigation?

Question

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The onset of puberty usually begins around 11 to 13 years of age. Stage 2 is the usual time of peak height velocity for girls. Additionally, both sweat and sebaceous glands become more active during adolescence leading to sweat, body odor, and acne. Breast buds also usually appear during stage 2 of puberty. Females who have not begun pubertal development by age 14 should have an endocrine evaluation. Thus, the finding of lack of breast buds on this 14-year-old girl requires further investigation.

A 14-Year-Old Female Is in for a Physical Exam