Breast: Normal Anatomy Flashcards Preview

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Flashcards in Breast: Normal Anatomy Deck (46)
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1
Q

What is the breast?

A
  • Secondary sexual feature of females
  • Rudimentary structure in males
  • Source of nutrition for neonates
2
Q

What is the association between the breast and malignancy?

A

Site of malignant change in as many as 1 in 10 women

3
Q

What does breast size and shape depend on?

A

Genetic, racial and dietary factors

4
Q

What are the general features of the breast?

A
  • Modified and highly specialized sweat glands
  • No special capsule or sheath
  • Well developed in females
5
Q

What is the surface markings of the breast?

A
  • Extends from 2nd/3rd rib to 6th rib

- Extends from sternal edge to midaxillary lie

6
Q

What is the axillary tail (of spence)/process?

A

A small part of the breast which may extends towards the axillary fossa

7
Q

What is the function of the retomammary space (bursa)?

A

Helps some degree of movement

8
Q

What does the breast lie on?

A
  • 2/3rd of the breast rests on the pectoral fascia covering pectoralis major
  • 1/3rd of the breast rests on the fascia covering serratus anterior
9
Q

How does the breast attach to the dermis?

A

By the suspensory ligament of cooper which helps support the lobules of the gland

10
Q

What is the nipple?

A

Prominence of the breast

11
Q

What is the areola?

A

Pigmented area around the nipple

12
Q

What is the basic structure of the breast?

A
  • Each breast contains 15-20 lobules of glandular tissue (parenchyma)
  • Each lobule is drained by a lactiferous duct – opens independently on the nipple
  • Each duct has a dilated portion – lactiferous sinus
13
Q

What are the features of the nipple?

A
  • No fat or hair
  • Contains collagenous dense connective tissue, elastic fibres and bands of smooth muscle
  • The tips of the nipples are fissured with lactiferous ducts opening into them
  • Position : variable or 4th intercostal space
14
Q

What are the features of the areola?

A
  • Skin covering the nipple and areola contains numerous sweat & sebaceous glands
  • Enlarge during pregnancy
  • Oily material secreted by the sebaceous gland provides a protective lubricant for nipple and areola
15
Q

How is the breast divided for description of pathology?

A

Into 4 quadrants

  • Superomedial quadrant
  • Inferomedial quadrant
  • Superolateral quadrant (axillary tail is an extension)
  • Inferolateral quadrant
16
Q

When does temporary enlargement of the male breast occur?

A

In the newborn and during puberty

17
Q

What are the features of the male breast?

A
  • Rudimentary throughout life
  • Formed by small ducts without lobules or alveoli
  • Little supporting fibroadipose tissue
18
Q

How does the breast develop?

A
  • Mammary crests or ridges appear during 4th week
  • These crests extend from axillary region to inguinal region
  • The crests usually disappear except in the pectoral region
  • Primary mammary buds – Secondary buds – lactiferous ducts and their branches
19
Q

Athelia

A

Absence of nipple

20
Q

Polythelia

A

An extra nipple

21
Q

Polymastia

A

An extra breast

22
Q

Amastia

A

Absence of breast

23
Q

Gynecomastia

A
  • Postnatal development of rudimentary lactiferous ducts in males
  • During puberty around 2/3rd of boys develop varying degrees of hyperplasia of the breasts
24
Q

What is the blood supply to the breasts?

A
Supplied by Branches of 
axillary artery, internal thoracic, and
some intercostal arteries
-Thoraco acromial artery
-Lateral thoracic artery
-Internal mammary (thoracic) artery
25
Q

What is the nerve supply to the breasts?

A

Anterior and lateral cutaneous branches of 4-6th intercostal nerves

  • They convey sensory fibres to the skin of the breast
  • They also carry sympathetic fibres to the blood vessels and to the smooth muscle around the nipple
26
Q

Why is the lymphatic drainage of the breast of great clinical significance?

A

Metastatic dissemination occurs primarily by the lymphatic routes

27
Q

What is the lymphatic drainage of the beast?

A
  • Most lymph (more than 75%) from lateral quadrants – axillary lymph nodes
  • Some lymph may drain directly to supraclavicular or inferior cervical nodes
  • Lymph from medial quadrants – parasternal or to opposite breast
28
Q

What is the sentinel node?

A

First draining node

29
Q

How is the sentinel localised?

A
  • A radiolabelled colloid is used to locate the sentinel node
  • At the time of surgery, a vital blue dye is injected
  • Combination of radioisotope and dye provides most accurate means of localizing the node
30
Q

What is identification of the sentinel node used for?

A

Lymphatic mapping and staging of patients

31
Q

What is the soft tissue of the breast made from?

A

Made up of lobes which contains a network of glandular tissue consisting of branching ducts and secretory lobules in a connective tissue stroma.

32
Q

What is the terminal duct lobular unit?

A

Functional milk secretory component of the breast

33
Q

Describe the connective tissue stroma which surrounds the lobules in the breast.

A

It is dense and fibrocollagenous

34
Q

Describe the interlobular tissue of the breast?

A

Loose texture

35
Q

What can be seen on histology of the breast?

A
  • Extensive branching duct system
  • Surrounded by dense fibrous interlobular tissue and adipose tissue
  • Ducts and acini are lined by 2 layers of cells: luminal epithelial cells and myoepithelial cells
36
Q

What age related changes occur in the breast prepuberty?

A
  • Neonatal breast contain lactiferous ducts but no alveoli
  • Until puberty, little branching of the ducts occurs
  • Slight breast enlargement reflects the growth of fibrous stroma and fat
37
Q

What age related changes occur in the breast during puberty?

A
  • Branching of lactiferous ducts
  • Solid, spheroidal masses of granular polyhedral cells (alveoli)
  • Accumulation of lipids in the adipocytes
38
Q

What age related changes occur in the breast post-menopausal?

A
  • Progressive atrophy of lobules and ducts

- Fatty replacement of glandular tissue

39
Q

What is colostrum?

A

Protein rich fluid, available for a few days after birth. It is rich in maternal antibodies

40
Q

What can be seen on histology of a lactating breast?

A
  • Acini distended with milk
  • Thin septa between the lobules
  • At higher magnification acini with eosinophilic material containing clear vacuoles can be seen?
41
Q

What stimulates milk production?

A
  • Suckling, neurohormonal reflex

- Prolactin and oxytocin

42
Q

What diagnostic methods are used in diagnosing breast pathology?

A
  • Imaging including mammography and ultrasound
  • Fine needle aspiration cytology
  • Core biopsy
43
Q

How common is breast cancer?

A
  • 20% of all cancers in women
  • Commonest cause of death in women in 35-55 age group
  • In UK, any woman has a 1in 9 chance of developing breast cancer
44
Q

What are some signs of breast cancer?

A
  • Skin dimpling
  • Oedema of skin
  • Abnormal contours
  • Nipple retraction and deviation
45
Q

Give examples of benign breast tumours.

A
  • Fibroadenomas
  • Duct papillomas
  • Adenomas
  • Connective tissue tumours
46
Q

What are the features of Paget’s disease?

A
  • Erosion of the nipple resembling eczema

- Associated with ductal or invasive carcinoma