Part 3: Breast

Question 1

Base of the breast

Answer 1

2-6 ribs, from midline to mid axillary line

Question 2

Breast overlies which muscles

Answer 2

Pec major, SAM and small part of rectus sheath

Question 3

Tubercles of Montgomery are?

Answer 3

Large sebaceous glands under areolar forming elevations

Question 4

Suspensory ligaments are attached to what?

Answer 4

Thickened superficial fascia which forms posterior capsule and connect to dermis of overlying skin (Coopers ligaments)

Question 5

What is the retro-mammary space?

Answer 5

Between posterior capsule and fascia of Pec Major. Traversed by lymph vessels. Used for prosthesis

Question 6

Blood supply of breast

Answer 6

Mainly by Lateral thoracic artery which curls around pec major.
Also internal thoracic through 2nd to 3rd spaces and IC arteries and pectoral branch of thoracoacromial artery supplies upper part

Question 7

Venous drainage of breast

Answer 7

Deep veins to internal thoracic and axillary veins, some to posterior IC

Question 8

Lymph drainage of breast

Answer 8

Lateral - axillary and infraclavicular nodes
Medial - internal thoracic and parasternal nodes
There can be significant med/lateral cross flow in addition to L/R cross flow

Question 9

Nerve supply of breast

Answer 9

Cutaneous branch of IC N. Sympathetic nerves supply glands and vessels

Question 10

Describe structure of the breast

Answer 10

Fibrous and fatty tissue account for majority of size with glandular tissue sparse in the resting breast. Fibrous septa divide breast into lobules which drain via lactiferous ducts, converging on the nipple

Question 11

Which structures are at risk in axillary dissection?

Answer 11

Long thoracic and thorocodorsal nerves

Lateral pectoral nerve to lesser extent