The Breast

Question 1

What is the role of oestrogens in breast development?

Answer 1

Stimulates ductal system proliferation and branching.

Question 2

What does prolactin influence during breast development?

Answer 2

Nipple growth and lobular-alveolar development.

Question 3

Which hormone promotes growth of areola during pregnancy?

Answer 3

Serum placental lactogen.

Question 4

What effect does progesterone have on the breast?

Answer 4

Promotes growth of lobes, lobules, alveoli, and duct widening.

Question 5

How do ACTH and hGH contribute to mammary growth?

Answer 5

They synergize with prolactin and progesterone.

Question 6

From which embryonic layers is breast tissue derived?

Answer 6

Ectoderm and mesoderm.

Question 7

When is complete mammary differentiation fully achieved?

Answer 7

During pregnancy and lactation.

Question 8

What are milk lines?

Answer 8

Thickened epithelial ridges forming from the 5th week gestation.

Question 9

What is the difference between breast development in childhood and puberty?

Answer 9

Childhood: isometric; Puberty: allometric.

Question 10

At what age do primary and secondary ducts form in girls?

Answer 10

10–12 years.

Question 11

What causes irreversible mammary development in women?

Answer 11

Each reproductive cycle.

Question 12

Between which ribs is the breast located?

Answer 12

2nd rib to 6th intercostal space.

Question 13

What are the two major components of the breast?

Answer 13

Parenchyma and stroma.

Question 14

What determines breast size?

Answer 14

Fat content, not glandular tissue.

Question 15

What improves latch and helps babies locate the breast?

Answer 15

Tubercles of Montgomery and sebaceous fluid.

Question 16

What is the main blood supply to the breast?

Answer 16

Internal mammary artery (60%) and lateral thoracic artery (30%).

Question 17

Where does lymph from the breast mostly drain?

Answer 17

Axillary lymph nodes.

Question 18

Which nerves innervate the breast?

Answer 18

2nd to 6th intercostal nerves (mainly 4th-6th).

Question 19

What are the three stages of lactation?

Answer 19

1. Development & colostrum
2. Onset of milk (32-96 hrs post birth)
3. Maintenance.

Question 20

What triggers colostrum secretion?

Answer 20

Differentiation of alveolar epithelial cells into lactocytes (~16 weeks gestation).

Question 21

What change triggers onset of copious milk secretion after birth?

Answer 21

Rise in prolactin and fall in pregnancy hormones.

Question 22

What maintains long-term milk production?

Answer 22

Frequent milk removal and feedback inhibitor of lactation (FIL).

Question 23

What are lactocytes?

Answer 23

Milk-secreting cells in the alveoli.

Question 24

What cells surround the alveoli to eject milk?

Answer 24

Myoepithelial cells.

Question 25

What is prolactin responsible for?

Answer 25

Milk production.

Question 26

When are prolactin levels highest?

Answer 26

At night and with touch/stimulation.

Question 27

What is oxytocin responsible for?

Answer 27

Milk ejection ('let down').

Question 28

What can inhibit oxytocin release?

Answer 28

Stress.

Question 29

What behaviors do prolactin and oxytocin support?

Answer 29

Instinctive mothering and bonding.

Question 30

What is FIL?

Answer 30

A whey protein that inhibits milk synthesis when breasts are full.

Question 31

How does pressure in the breast affect milk production?

Answer 31

Flattens cells and receptor sites, reducing prolactin binding.

Question 32

Name 3 physiological effects of oxytocin.

Answer 32

Lowers BP, reduces stress/pain, improves sleep.

Question 33

How does oxytocin affect bonding?

Answer 33

Enhances emotional connection between mother and baby.

Question 34

Can synthetic oxytocin affect natural oxytocin levels?

Answer 34

Yes, it may negatively impact natural production.

Question 35

What is lactoferrin and its role in milk?

Answer 35

A transfer factor that aids iron absorption.

Question 36

What creates a low pH in the infant gut?

Answer 36

Bifidus factor promoting growth of Lactobacillus bifidus.

Question 37

Which enzyme in breastmilk aids fat digestion?

Answer 37

Lipase.

Question 38

What do breastmilk oligosaccharides do?

Answer 38

Prevent pathogens from adhering to gut wall.

Question 39

What type of antibodies does breastmilk contain?

Answer 39

SIgA and antibodies from entero- and broncho-mammary pathways.

Question 40

Does formula contain living cells and immune components?

Answer 40

No—formula is nutritionally adequate but lacks immune protection.

Question 41

What is a typical sign of mastitis?

Answer 41

Wedge-shaped area of inflammation and tenderness.

Question 42

What causes non-infective mastitis?

Answer 42

Poor attachment, tight clothing, or milk stasis.

Question 43

What percentage of mastitis cases are non-infective?

Answer 43

70%.

Question 44

When does mastitis most commonly occur?

Answer 44

Within the first 3 months postpartum.

Question 45

What bacteria is often involved in infective mastitis?

Answer 45

Staphylococcus aureus.

Question 46

Management for mastitis includes?

Answer 46

Breastfeeding, massage, compresses, analgesia, fluids, rest, correct latch.

Question 47

What is a breast abscess?

Answer 47

A collection of pus often due to untreated mastitis.

Question 48

How is a breast abscess treated?

Answer 48

Ultrasound-guided aspiration or surgical drainage, plus antibiotics.