Normal anatomy of the breast Flashcards

1
Q

How do the breasts develop?

A
  • Mammary crests or ridges appear during 4th week
  • These crests extend from axillary region to inguinal region
  • The crests usually disappear except in the pectoral region
  • Primary mammary buds – Secondary buds – lactiferous ducts and their branches
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2
Q

Describe the breasts?

A
  • Secondary sexual feature of females
  • Source of nutrition for the neonates
  • Present in a rudimentary form in males
  • Site of malignant change in as many as 1 in 10 women
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3
Q
A
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4
Q

What are the general features of the breast?

A

•Modified and highly specialized sweat glands

No special capsule or sheath

  • Both Males & females have breasts
  • Well developed in females
  • Breast size and shape result from genetic,racial, and dietary factors
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5
Q

What is the extent of the breast?

A

Vertical: 2nd or 3rd rib – 6th rib

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6
Q

What is the transverse location of the breast?

A

Sternal edge to midaxillary line

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7
Q

Where does the breast lie?

A

On the deep pectoral fascia

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8
Q

Where is the axillary tail?

A

A small part of breasts may extend towards axillary fossa

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9
Q

What does the retromarry space do?

A

Help some degree of movement

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10
Q

Where does the parts of the breast rest?

A
  • 2/3rd of the breast rests on the pectoral fascia covering pectoralis major
  • 1/3rd of the breast rests on the fascia covering serratus anterior
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11
Q

Where does the breast firmly attach?

A

To the dermis by suspensory ligament of cooper – help support the lobules of the gland

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12
Q

What is the nipple?

A

Prominence of the breast

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13
Q

What is the areola?

A

Pigmented area around the nipple

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14
Q

How many lobules of the breast?

A

•Each breast contains 15-20 lobules of glandular tissue (parenchyma)

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15
Q

What is each lobule of breast drained by?

A

Lactiferous duct – opens independently on the nipple

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16
Q

What is a lactiferous sinus?

A

Dilated portion of breast

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17
Q

What is important about a nipple?

A
  • No fat or hair
  • Contains collagenous dense connective tissue, elastic fibres and bands of smooth muscle
  • The tips of the nipples are fissured with lactiferous ducts opening into them
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18
Q

What is the position of the nipple?

A

variable or 4th intercostal space

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19
Q

What is important about the areola?

A
  • Skin covering the nipple and areola contains numerous sweat & sebaceous glands
  • Enlarge during pregnancy
  • Oily material secreted by the sebaceous gland provides a protective lubricant for nipple and areola
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20
Q

What are the breast quadrants?

A

•For anatomical location and description of pathology (cysts and tumours) the breast is divided into 4 quadrants.

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21
Q

What is the axillary tail an extension of?

A

Breast tissue in the supero-lateral quadrant

22
Q

Explain the male breast?

A
  • Rudimentary throughout life
  • Formed by small ducts without lobules or alveoli
  • Little supporting fibroadipose tissue
  • Temporary enlargement in newborn & during puberty
23
Q

What is gynaecomastia?

A
  • Postnatal development of rudimentary lactiferous ducts in males
  • During midpuberty about 2/3rd of boys develop varying degrees of hyperplasia of the breasts
24
Q

What is polymastia?

A

Extra breast

25
Q

What is polythelia?

A

An extra nipple

26
Q

What is athelia or amastia?

A

Absence of nipple or breast

27
Q

What is the breast supplied by?

A

Branches of axillary artery, internal thoracic, and some intercostal arteries

  • Thoraco acromial artery
  • Lateral thoracic artery
  • Internal mammary (thoracic) artery
28
Q
A
29
Q

What are the nerves of the breast?

A
  • Anterior and lateral cutaneous branches of 4-6th intercostal nerves
  • They convey sensory fibers to the skin of the breast
  • They also carry sympathetic fibres to the blood vessels and to the smooth muscle around the nipple
30
Q

What is the lymphagtic drainage of the breast?

A
  • Great clinical significance because metastatic dissemination occurs primarily by the lymphatic routes
  • Breast lymphatics branch extensively and do not contain valves
  • Most lymph (more than 75%) from lateral quadrants – axillary lymph nodes
  • Some lymph may drain directly to supraclavicular or inferior cervical nodes
  • Lymph from medial quadrants – parasternal or to opposite breast
31
Q

What is the role of sentineal lymph node biopsy?

A

•Lymphatic mapping & staging of patients

•A radiolabelled colloid is used to locate the sentinel node

•At the time of surgery, a vital blue dye is injected

•Combination of rodioisotope and dye provides most accurate means of localizing the node

32
Q

What is breast soft tissue made up of?

A

Of lobes which contains a network of glandular tissue consisting of branching ducts and secretory lobules in a connective tissue stroma.

33
Q

What is the termianl duct lobular unit of breast?

A

•lobular unit is the functional milk secretory component of the breast

34
Q

connective tissue stroma that surrounds the lobules of breast is what?

A

dense and fibrocollagenous, whereas intralobular tissue has a loose texture

35
Q

What is the normal breast like?

A

Extensive branching duct system

Surrounded by dense fibrous interlobular tissue (F) & adipose tissue (A)

Ducts & acini are lined by two layers of cells – Luminal epithelial cells (E) & myoepithelial cells (M)

36
Q

What are the prepuberty age related changes of breasts?

A
  • Neonatal breast contain lactiferous ducts but no alveoli
  • Until puberty, little branching of the ducts occurs
  • Slight breast enlargement reflects the growth of fibrous stroma and fat
37
Q

What are the puberty related changes of breasts?

A

•Branching of lactiferous ducts

•Solid, spheroidal masses of granular polyhedral cells (alveoli)

•Accumulation of lipids in the adipocytes

38
Q

What are the post menopausal age related changes of breasts?

A
  • Progressive atrophy of lobules and ducts
  • Fatty replacement of glandular tissue
39
Q

What kind of breasts are these and answer the labels

A

Breast during pregnancy

40
Q

What happens to the breasts during pregnancy?

A
  • Enlarged lobules
  • Acini are dilated
  • Epithelium vary from cuboidal to low columnar
41
Q

What is colostrum?

A

Protein rich fluid, available few days after birth – rich in maternal antibodies

42
Q

What kind of breasts are these?

A

Lactating breast

43
Q

What are important parts of the lactating breast?

A
  • Acini distended with milk
  • Thin septa (S) between the lobules
  • At higher magnification (b) – Acini with eosinophilic material containing clear vacuoles
  • Milk production – Suckling -Neurohormonal reflex –Prolactin & Oxytocin
44
Q

What are the diagnostic methods for breaast conditions?

A
  • Imaging –Mammography and Ultrasound
  • Fine needle aspiration cytology
  • Core biopsy
45
Q
A
46
Q

What is shown in this mammogram?

A

Mammogram of a fatty breast with an obvious cancer

47
Q

What is the commonest cause of death in women age 35-55?

A

Breast cancer

48
Q

What is the risk of breast cancer in UK women?

A

1 in 9 chance of developing breast cancer

49
Q

What are some signs of breast cancer?

A

Skin dimpling

Abnormal contours

Edema of skin

Nipple retraction and deviation

50
Q

What are some examples of benign breast tumours?

A
  • Fibroadenomas
  • Duct papillomas
  • Adenomas
  • Connective tissue tumours