Flashcards in Breast Deck (14)
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Lies in superficial fascia of anterior chest wall
Overlies the PECTORALIS MAJOR & SERRATUS ANTERIOR MUSCLES
Axillary tail - high percentage of tumors
Extends from rib 2-6 vertically, from sternum to MAL laterally
Breast
1
Between breast & pectoral (deep) fascia
- allows free movement of the breast
- cancer invasion --> pectoralis major contraction --> whole breast move superiorly
Retromammary space
2
For support
Extends from dermis to pectoral (deep) fascia
Cancer invasion --> skin dimpling or nipple inversion
Suspensory (cooper) ligament
3
For contour & size
Adipose tissue
4
Modified sweat glands consisting of acini
Acini --> 15-20 lactiferous ducts --> lactiferous sinus (milk reservoir) --> nipple
Glandular tissue (mammary gland)
5
Arterial supply
Internal thoracic artery
Lateral thoracic artery
Intercostal artery
6
Venous drainage
Chief: Axillary vein
Others: internal thoracic vein, lateral thoracic vein, intercostal vein
7
Lymphatic drainage
Chief: Axillary nodes
Cancer invasion --> block lymph flow --> thick, leathery skin (peau d orange)
8
Sensory innervation
Intercostals nerves 2-6
9
Nipple secretion
Contents:
- exfoliates duct cells
- a-lactoalbumin
- immunoglobulins
- lactose
- cholesterol
- steroids
- fatty acids
- caffeine, ethanol, nicotine, barbiturates, pesticides & technetium
10
Nipple discharge
Benign cause:
- green, milky, yellow or brown
- bilateral
- not spontaneous
- affects multiple ducts
PITUITARY ADENOMA (prolactinoma)
- Galactorrhea + headache + loss of peripheral vision
Malignant cause:
- bloody or clear (serous)
- unilateral
- spontaneous
- affects a single duct
11
Benign, glands are compressed into cords of epithelium
Sharply circumscribed, spherical nodule, movable
Fibroadenoma
12
Most common breast cancer
Malignant, arranged in cell nests, cords,, anastomosing masses
Jagged-edged, fixed mass
If (+) estrogen/progesterone receptor --> good prognosis
If (+) c-erb B2 oncoprotein --> poor prognosis
Mutation of BRCA 1 (a tumor suppressor gene) --> very high lifetime risk of breast & ovarian cancer
Infiltrating ductal carcinoma
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