Breast - Repro Y3

Question 1

function

Answer 1

source of nutrition for neonates - production of human milk

Question 2

location and relations

Answer 2

vertical extent: 2nd/3rd rib - 6th rib
transverse: sternal edge to midaxillary line

lies on deep pectoral fascia

Question 3

which muscles do they cover

Answer 3

2/3 rests on pectoral fascia covering pectoralis major
1/3 rests on fascia covering serratus anterior

Question 4

how are attached to dermis

Answer 4

suspensory ligament of cooper - support the lobules of the gland

Question 5

structure - nipple

Answer 5

prominence of breast

Question 6

structure - areola

Answer 6

pigmented area around the nipple

Question 7

structure - glandular tissue

Answer 7

contains around 15-20 lobules of glandular tissue (parenchyma)

Question 8

how are lobules drained

Answer 8

lactiferous duct - opens independently on the nipple

Question 9

dilated portion of duct

Answer 9

lactiferous sinus

Question 10

nipple features

Answer 10

no fat or hair
contains collagenous dense connective tissue, elastic fibres and bands of smooth muscle
tips of nipples are fissured with lactiferous ducts opening into them
position: variable or 4th ICS

Question 11

areola features

Answer 11

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

Question 12

4 quadrants of breast

Answer 12

superolateral quadrant
superomedial quadrant
inferolateral quadrant
inferomedial quadrant

Question 13

what is extension of superolateral quadrant called

Answer 13

axillary tail

Question 13

gynecomastia

Answer 13

postnatal development of rudimentary lactiferous ducts in males
during midpuberty about 2/3 of boys develop varying degrees of hyperplasia of the breasts

Question 13

define polymastia

Answer 13

an extra breast

Question 14

define polythelia

Answer 14

extra nipple

Question 15

define athelia or amastia

Answer 15

absence of nipple or breast

Question 16

function of ligaments (of Cooper)

Answer 16

attach and secure breast to dermis and underlying pectoral fascia
separate the secretory lobules of the breast

Question 16

arterial supply to medial aspect of breast

Answer 16

internal thoracic artery (aka internal mammary artery) - branch of subclavian artery

Question 17

retromammary space

Answer 17

between breast and pectoral fascia - often used in reconstructive plastic surgery

Question 18

arterial blood supply to lateral aspect of breast

Answer 18

lateral thoracic and thoracoacromial branches - originate from axillary artery
lateral mammary branches - post intercostal arteries (derived from aorta)
— supply lateral aspect in 2nd, 3rd and 4th ICS
mammary branch - originates from anterior intercostal artery

Question 19

venous drainage

Answer 19

veins correspond with the arteries, draining into the axillary and internal thoracic veins

Question 20

lymphatic drainage

Answer 20

axillary nodes (75%)
parasternal nodes (20%)
posterior intercostal nodes (5%)

skin also receives lymphatic drainage
skin - drains to axillary, inferior deep cervical and infraclavicular nodes
nipple and areola - drains to subareolar lymphatic plexus

Question 21

nerves of breast

Answer 21

anterior and lateral cutaneous branches of 4th-6th intercostal nerves
- sensory fibres to skin of breast
- sympathetic fibres to blood vessels and smooth muscle around nipple

Question 22

role of sentinel lymph node

Answer 22

first lymph node to which cancer cells are most likely to spread from a primary tumour

Question 23

finding sentinel node

Answer 23

radiolabelled colloid
at time of surgery, vital blue dye is injected
combination of radioisotope and dye provides most accurate means of localising the node

Question 24

prepuberty breast

Answer 24

neonatal breast contain lactiferous ducts but no alveoli
until puberty, little branching of ducts occurs
slight enlargement reflects growth of fibrous stroma and fat

Question 25

puberty breast

Answer 25

branching of lactiferous ducts
solid, spheroidal masses of granular polyhedral cells (alveoli)
accumulation of lipids in the adipocytes

Question 26

post menopausal breast

Answer 26

progressive atrophy of lobules and ducts
fatty replacement of glandular tissue

Question 27

colostrum

Answer 27

protein rich fluid, available few days after birth - rich in maternal antibodies

Question 28

diagnostic methods for breast cancer

Answer 28

imaging - mammography and ultrasound
fine needle aspiration cytology
core biopsy

Question 29

Paget’s disease of nipple

Answer 29

erosion of nipple resembling eczema
associated with ductal or invasive carcinoma

Question 30

benign breast tumours

Answer 30

fibroadenomas
duct papillomas
adenomas
connective tissue tumours