Breast Anatomy and Pathophysiology

Question 1

Breast tissue lies on what?

Answer 1

Pectoral fascia

Question 2

What does the retrommamary space allow for?

Answer 2

Movement via bursal tissue

Question 3

What ligament supports the breast superiorly?

Answer 3

Suspensory ligaments

Question 4

Lactiferous ducts are attached to what?

Answer 4

Lobules of the mammary gland

Question 5

What will compress the areola and stimulate hormonal mediated let-down reflex?

Answer 5

Nursing

Question 6

Venous drainage is from what vein primarily?

Answer 6

Axillary

Question 7

Where does the axillary lymph nodes drain?

Answer 7

Drain into the clavicular nodes –> subclavian –> lymphatic trunk

Question 8

When does breast tissue stop growing and will diminish?

Answer 8

Around 35 years of age

Question 9

What hormone promotes breast gland growth?

Answer 9

Progesterone

Question 10

What is the first sign of puberty in women?

Answer 10

Breast development (“breast buds”)

Question 11

How long does full breast development take?

Answer 11

About 4 years

Question 12

What hormone develops the functional cells that line the acini?

Answer 12

Progesterone

Question 13

What hormone stimulates milk production?

Answer 13

Prolactin

Question 14

What hormone stimulates let-down?

Answer 14

Oxytocin

Question 15

What is the first milk produced after delivery?

Answer 15

Colostrum

Question 16

Where do fibrotic changes typically palpated?

Answer 16

upper/outer breast tissue

Question 17

What is the pathophysiology of fibrocytic breasts?

Answer 17

No difinitive cause, thought to be associated with alteration of estrogen/progresterone or increase in prolactin

Question 18

How do fibroadenoma’s present?

Answer 18

Firm, well-circumscribed, mobile, and painless mass

Typically a solitary mass

Question 19

Does fibroademoa’s increase the risk of breast cancer?

Answer 19

No

Question 20

What is the cause of fibroadenoma’s?

Answer 20

Overgrowth of epithelial and supporting structural cells

Question 21

What is mastitis?

Answer 21

Inflammation of breast tissues typically with breast feeding

*If seen in non-breastfeeding pt, need to think of underlying issue

Question 22

When are you concerned for infection for infectious etiology in mastitis?

Answer 22

12-24 hours after onset of symptoms (fever)

Question 23

What pathogen is most common in mastitis?

Answer 23

S. aureus

Question 24

What are the most common associated diagnosis with galactorrhea?

Answer 24

Hypothalamic pituitary disorders
Pituitary tumors
Trauma

Question 25

What does red discharge from the breasts suggest?

Answer 25

Cancer

Question 26

Galactorrhea is most commonly caused by

Answer 26

Hyperprolactonemia

Question 27

When is gynecomastia normal?

Answer 27

Puberty (resolves in 6 mo)

Question 28

What is the normal role of the BRCA genes?

Answer 28

tumor suppression

Question 29

What are the functional units of the lobules?

Answer 29

Acini, lined with epithelial cells and can secrete milk

Question 30

What cell type allows for ejection of milk?

Answer 30

Underlying the acini are myoepithelial cells that can contract to cause ejection of the milk

Question 31

When is pain most common in fibrocystic breast changes?

Answer 31

Around time of menstruation