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RE > Breast > Flashcards

Breast Flashcards

1
Q

How many new breast cancers occur in the UK annually?

What is the risk?

A

56K - incidence expected to rise by 2%

Risk = 1 in 9

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2
Q

What type of gland is in the breast tissue?

A

Modified apocrine (sweat) gland

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3
Q

What is an additional nipple called?

A

Accessory nipple

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4
Q

What is an absence of nipple & areola called?

A

Athelia

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5
Q

What is an absence of breast tissue, but presence of nipple & areola complex called?

A

Amastia

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6
Q

What type of breast shape do pre-pubertal girls get as part of development - which can be pathological if it doesn’t progress?

A

Tubular breast

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7
Q

Upon what do the breasts lie?

A

Pectoralis major - from 2nd to 6th rib

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8
Q

Which muscle is laterally related to the breast?

A

Serattus anterior

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9
Q

Which muscles lie inferiorly to the breast?

A

Rectus abdominus and inferolaterally - external oblique

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10
Q

Where is the nipple found anatomically?

A

Mid-clavicular line, 4th intercostal space

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11
Q

What lies in the retromammary space?

A

Fat

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12
Q

How does the breast attach to the pectoral fascia?

A

By suspensory ligaments extending from dermis of breast to pectoral fascia

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13
Q

What divides the breast tissue into segments?

A

Suspensory ligaments - called Cooper’s ligaments

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14
Q

What are the sebaceous glands of the areola called?

A

Montgomery glands

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15
Q
A
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16
Q

What does the nipple and areola contain?

A

Sweat glands
Sebaceous (Montgomery) glands

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17
Q

Where does the upper and outer breast extend into? What is this called?

A

Extends into the axilla

Called axillary tail

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18
Q

What type of cells are the ducts and lobules of the breast tissue lined with?

A

Columnar epithelium - with myoepithelial cells in the basement membrane

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19
Q

What happens to the breast tissues during the menstrual cycle?

A

The structure can fluctuate - causing breast tissue to get bigger - causing breast pain. Can get firm lumpy areas due to hormonal changes.

20
Q

How many lobules are found in each breast?

A

15-20

21
Q

What are the ducts of the breast called?

A

Lactiferous ducts

22
Q

What do lactiferous ducts converge to become and where?

A

Converge to become lactiferous sinus - found at the nipple

23
Q

When do you get hormonal changes in breasts?

A

Puberty
Menstruation
Lactation
Menopause

24
Q

What happens to breast tissue in menopause?

A

The reduction of oestrogen causes much of the glandular tissue to be replaced with fatty tissue (involution).

25
Q

What happens to the breast during lactation?

A

The secretory lobules and ducts become enlarged.

26
Q

Which artery supplies the breast?
What are the 3 main arterial branches of this?

A

Axillary artery

  • Thoracodorsal
  • Thoraco-acromial
  • Lateral thoracic
27
Q

What provides 60% of blood supply to the breast?

A

Internal mammary perforators - these are vessels which arise from the mammillary artery and perforate through the chest wall.

28
Q

What provides superficial venous drainage of the breast?

A

Nipple and areola complex venous plexus - drains into intercostal veins

29
Q

Where does venous drainage of the deep breast tissue go?

A

Into the axillary, internal thoracic vein and perforating intercostal veins

30
Q

What are the two types of lymph vessels in the breast?

A

Superficial and deep - relate to vascular structures - drain into local lymph nodes.

31
Q

What types of lymph nodes are in the breast?

A

Local
Regional
Central

32
Q

What is the path of lymph flow in the breast?

A

Local –> Regional –> Central –> Venous Circulation (thoracic duct -> left subclavian vein)

33
Q

Name two locations of superficial lymph nodes in the breast. Which direction do they drain in?

A

Areola
Subareola

Drain sideways and upwards

34
Q

Where does the axillary artery arise from?

A

The subclavian artery

35
Q

Where do internal mammary lymph nodes (intra mammary lymph) drain?

A

To lateral aspect and into axillary nodes - again sideways and upwards.

36
Q

What can happen in inflammatory breast cancer?

A

The lymphatics can be occluded causing oedema within the breast tissue.

37
Q

What is peau d’orange appearance associated with?

A

Breast cancer

38
Q

Where do lymph nodes of the breast and upper limb drain into?

A

The axilla

39
Q

What are the different levels of axillary drainage within the breast?

A

Lower
Middle
Superior

40
Q

What is the first lymph node in the chain of lymphatic drainage called?

A

Sentinel lymph node

41
Q

How are sentinel lymph nodes used in breast cancer?

A

Rather than removing all lymphatics - try to identify the sentinel nodes which are involved using blue / radioactive dye injected S/C - can detect which sentinel node has taken up the dye - these can then be removed.

42
Q

Where does main sensory supply to the breast originate from?

A

The lower cervical plexus (superior)
Long thoracic nerve (laterally)
Intercostal nerves (2nd-6th)

43
Q

Where does autonomic supply of the breast originate from?

A

2nd - 6th intercostal nerves

44
Q

What supplies sensation to the nipple?

A

Lateral cutaneous branch of T4

45
Q

What is the dermatome of the nipple?

A

T4

RE (5 decks)

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