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LC 02 > Breast Dev + Phys > Flashcards

Breast Dev + Phys Flashcards

1
Q

How long does the AAP recommend breastfeeding newborns for?

A

6 months

- nutritional and health advantage

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2
Q

How is having your first child protective against having breast cancer (timeline)?

A

First 10 years following first birth
- increased risk for breast cancer

Then having a baby is protective in later years
- earlier you have a kid, sooner it kicks in?

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3
Q

How is breast feeding beneficial to the baby?

A
  1. reduced incidence of infectious diseases
  2. Reduced post natal infant mortality rates
  3. Decreased incidence of SIDS
  4. Improved cognitive fxn
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4
Q

Breast feeding benefits for mom

A
  1. Decreased postpartum bleeding and more rapid uterine involution
    (oxytocin)
  2. Decreased menstrual blood loss and increased child spacing
    (lactational amenorrhea)
  3. Earlier return to pre-pregnancy weight
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5
Q

Lobes of the breast

  • what are they
  • what are they composed of?
  • Importance?
A

glandular units of the breast

  • composed of multiple lobules containing alveoli (milk producing units)
  • Milk ducts form multiple lobes feed into the nipple
  • Glandular structures during lactation are the most prominent component of breast (62%) (when non lactating, intraglandular fat is largest at 49%) - 3 fold increase
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6
Q

Describe breast anatomy from stroma –> nipple

A

Stroma –> Lobules –> Terminal duct –>

Major duct –> Lactiferous sinus –> Nipple

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7
Q

Non lactating breast is mainly composed of what?

A

Intraglandular fat (49%)

*vs lactating breast have more glandular structures (62%)

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8
Q

Lactation cycle and how architectural changes occur (list the 5 distinct secretory pathways)

A

Get pregnant:

  1. Glandular morphogenesis –>
  2. Secretory differentiation –>
  3. Lactation –>
  4. Involution - apoptosis, glandular regression and return to quiescence
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9
Q

Embryonic development of breast

A
  1. Ectodermal origin –>
  2. Invaginates into underlying mesenchyme –>
  3. Starts off as primary bud –>
  4. Becomes secondary bud –>
  5. Invaginates into fat pad
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10
Q

What induces differentiation of dermal mesenchyme to mammary mesenchyme?
What happens if it isnt present?

A

PTHrP secreted by epithelial cells.

  • without it, no dermal mesenchymal condensation occurs and no differentiation into to mammary mesenchyme
  • Mammary mesenchyme doesnt develope and secrete signals to stimulate nipple formation –> primary bud epithelial cells regresses
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11
Q

Blomstrands chondroplasia (amastia)

A

absence of PTHrP –> primary bud epithelial cells regresses –> no nipple or mammary morphogenesis

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12
Q

Mom’s Elevated prolactin and decreased progesterone at parturition can induce what in the infant?

A

Hormonal changes act on baby (a little bit)

- temporary milk secretion in both male and female neonates (witches milk)

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13
Q

How long do progesterone receptors present in glandular elements in the neonate last for?

A

3 months after birth

- Temporary GnRH driven spike in progesterone during infancy stimulates branching and lobule fxn

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14
Q

What elaborates in puberty?

A

Ductal morphogenesis –

  • driven by E (principal regulator) and P
  • macroscopic breast development ends at age 15, but fxnal development continues on
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15
Q

Formation of ductal network and lobules are regulated ______

A

independently

- by two different ovarian hormones

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16
Q

Which phases of the menstrual cycle/hormones do the alveoli and ducts primarily mature in?

A

Ducts: Around ovulation

  • E in combo with GH induce elongation and branching of the ductal network by increasing IGF-1 production by stromal cells
  • E is just the activator, IGF-1 is the money maker

Alveoli: secretory phase (Progesterone)
- P during the luteal phase brings about side branching and lubulo-alveolar development

17
Q

During pregnancy, which morphogenesis occurs?

A

Glandular morphogenesis

  • associated with secretory differentiation
    1. Lactogenesis-1
  • initiation of milk protein expression and development of secretory capacity
    2. Lactogenesis-2
  • copious milk production
18
Q

What is essential for producing a robust side branching of lobuloalveolar formation

A

Prolactin + progesterone

  • progesterone alone not enough for formation of mature alveoli ***
  • Milk product synthesis is initiated during pregnancy by the actions of prolactin or placental lactogen but milk secretion is held in check by high progesterone levels
19
Q
  • Milk product synthesis is initiated during pregnancy by the actions of ______ or ______ but milk secretion is held in check by high ______levels
A

Prolactin
placental lactogen

progesterone

20
Q

Milk secretion is initiated by the fall in ____ at parturition.

A

Progesterone
(due to removal of placenta!)
(remember progesterone holds milk secretion in check)
- even if a small amt of placenta is left behind, woman will not be able to lactate

21
Q

Elevated prolactin levels is required to:

A

maintain milk synthesis and secretion

Pituitary kicks in and makes more prolactin

22
Q

How does suckling allow for lactation?

A
  1. Suckling stimulated afferent activation of the hypothalamus
  2. Hypothalamic regulated production and release of prolactin and oxytocin
    - inhibits hypothalamic DA release –> no more inhibition of prolactin
  3. Prolactin/Oxytocin mediated secretion and ejection

*prolactin is normally inhibited by DA

23
Q

Which hormone is involved in:

  1. Milk removal
  2. Milk ejection
A
  1. Milk removal: prolactin (milk synthesis and secretion)
  2. Milk ejection: oxytocin

*milk removal is required to maintain glandular integrity and milk production

24
Q

INfant suckling leads to downregulation of what?

A

DA and GnRH

- women who are lactating are less likely to get pregnant

25
Q

Suckling is required to maintain _____ levels. Failure to initiate breastfeeding shortly after parturition diminishes what?

A

prolactin
- failure to initiate breastfeeding shortly after parturition diminishes PROLACTIN signaling and impairs milk synthesis and secretion

-Particular problem for women that deliver preterm infants –> milk production capacity of the mother and suckling ability of the infant are both immature

26
Q

Particular lactation problem for women that deliver preterm infants

A

milk production capacity of the mother and suckling ability of the infant are both immature

27
Q

Milk ejection requires _____ to be squeezed, and _____ to be released.

A

alveoli (by myoepithelial cells)
- oxytocin is also required for milk ejection: stimulates contraction of myoepithelial cells that form a basket-like network around alveoli

Suckling stimulates synthesis and release of oxytocin from hypothalamic neurons

28
Q

Factors negatively affecting lactation

A
  1. Anxiety/stress
  2. Delayed lactation initiation
  3. Pituitary disorders or damage
  4. Excessive weight
29
Q

How does excessive weight affect lactation

A

Decreased ability to initiate lactation and maintain lactation
- Produce less prolactin
- cannot efficiently mobilize energy for lactation
(fat is selfish)

30
Q

Energetic demand during lactation

A

Energy maintenance requirement are increased by 20%

31
Q

Diff between human milk and bovine milk

A

hu milk has higher levels of oligo saccharides

  • antimicrobial (prevent bad bacteria)
  • promicrobial (proper gut bacteria)
32
Q

Immune vs nutritional component of milk following parturition

A

2 days post partum:

  • high serum IgA (colostrum)
  • transfer passive immunity (tight jxns are open)

> 2 days:

  • tight jxns close + switch from immune to nutritional fxn:
  • milk volume gets high, sIgA gets low
33
Q

If baby is not suckling, tight jxns _____

A

open

not closing properly

34
Q

what are the only cells capable of producing milk?

A

LOBULAR LUMINAL cells

  • recall luminal cells overlay the myoepithelial cells
  • In childhood, female breasts has branching ductal system WITHOUT lobular units
35
Q

how do male breasts differ from female

A

no tubules (acini)

36
Q

At puberty, what structures are stable and unaffected by hormones, and which are dynamic and undergo changes with alterations in hormone levels?

A

Lactiferous ducts + interlobular duct = stable

TDLU = dynamic
- changes involve epithelium and intralobular stroma

37
Q

Lobules and cell # of breasts during the different stages of menstruation

A

First half of menstrual cycle:
- lobules are quiet

After ovulation:
- E and rising Progesteron –> cell proliferation and + of acini per lobule + intralobular stroma bcomes edematous

Upon menstruation:
- Fall in E + P –> regression of lobules and disappearance of stromal edema

38
Q

Menopause change in breast

A

lobules and their specialized stroma start to involute

  • lobular atrophy may be almost complete
  • Radiodense fibrous stroma –> radiolucent adipose tissue
39
Q

Cause of Gynecomastia

A

most are idiopathic

- some are due to excessive estrogen

LC 02 (15 decks)

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