The school nurse teaches a group of school-age girls about sexual development. Which statement is most accurate?

Female puberty follows a predictable sequence driven by hypothalamic-pituitary-ovarian axis activation, resulting in estrogen-mediated thelarche, pubertal growth spurt, and eventual menarche. The timing reflects progressive ovarian follicular maturation and endocrine feedback maturation across adolescence. Rationale: A. Menstruation precedes breast development by about 4 years is physiologically incorrect. Menarche never occurs before thelarche in normal pubertal development. Estrogen-driven breast tissue proliferation is an early secondary sexual characteristic preceding menstrual cycle establishment. B. Breast development precedes menstruation by about 4 years overestimates the typical interval. Although thelarche occurs first, the average lag between breast development and menarche is significantly shorter than 4 years. This timing does not reflect standard pubertal physiology. C. Breast development precedes menstruation by about 2 years accurately reflects normal pubertal sequencing. Thelarche is initiated by rising estrogen levels from ovarian activity, followed by pubarche and growth acceleration, with menarche occurring approximately 2 to 3 years later. D. Menstruation precedes breast development by about 2 years is incorrect because menarche is not the initiating event of puberty. Breast development is one of the earliest visible signs of estrogen exposure and always occurs before the onset of menstruation in normal development.