15.1. Breasts - Normal Breast Anatomy Flashcards

1
Q

What are Breasts?

A
  1. Secondary Sexual Feature of Females

2. Source of Nutrition for Neonates

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2
Q

What are the General Features of Breasts?

A
  1. Modified and Highly Specialised Sweat Gland
  2. No Special Capsule / Sheath
  3. Well Developed in Females (Present in Males too)
  4. Breast Size / Shape results from Genetic / Racial and Dietary Factors
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3
Q

Where are the Breasts located?

What is it located over?

A
  1. Vertical - 2nd / 3rd Rib to 6th Rib
  2. Transverse - Sternal Edge to Mid-Axillary Line
  3. Lies over the Deep Pectoral Fascia
  4. Axillary Tail / Process - A Small part of the Breast may extend to the Axillary Fossa
  5. Retromammary Space - Helps some degree of Movement
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4
Q

How does the Breast relate to the:

  1. Pectoralis Major?
  2. Serratus Anterior?
  3. Dermis?
A
  1. 2/3rds of the Breast Rests on the Pec. Major
  2. 1/3rd of the Breast Rests on the Ser. Anterior
  3. Firmly attached to the Dermis by the Suspensory Ligament of Cooper (Helps support the Lobules of the Gland)
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5
Q

What is the:

  1. Nipple?
  2. Areola?
A
  1. Prominence of the Breast

2. Pigmented Area around the Nipple

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6
Q

How many Lobes / Lobules of Glandular Tissue does Each Breast Contain?

A

Lobes - 8-10

Lobules - 15-20

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7
Q

What is Each Lobule of Glandular Tissue in the Breast drained by?

A

Lactiferous Duct - opens independently on the Nipple

Note - Each Duct has a Lactiferous Sinus (Dilated Portion)

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8
Q

What are the Features of the Nipple?

A
  1. No Fat
  2. No Hair
  3. Contains Collagenous Dense Connective Tissue, Elastic Fibres and Bands of Smooth Muscle
  4. The Tips of the Nipples are Fissured with Lactiferous Ducts opening into them
  5. Position - 4th Intercostal Space (Variable)
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9
Q

What are the Features of the Areola?

A
  1. Skin covering the Nipple
  2. Contains numerous Sweat and Sebaceous Glands
  3. Enlarge during Pregnancy
  4. Oily material Secreted by the Sebaceous Gland provides protective Lubricant for Nipple / Areola
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10
Q

What are the 4 Breast Quadrants?

A
  1. Superolateral Quadrant
  2. Superomedial Quadrant
  3. Inferolateral Quadrant
  4. Inferomedial Quadrant
    Note - These are used in Description of Pathology
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11
Q

Where is the Axillary Tail Located?

A

Extension of the Breast Tissue in the Superlateral Quadrant

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12
Q

What are the Features of the Male Breast?

A
  1. Rudimentary throughout Life
  2. Formed by small Ducts without Lobules or Alveoli
  3. Little supporting Fibroadipose Tissue
  4. Temporary enlargement in Newborn / Puberty
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13
Q

How do the Breasts develop?

A
  1. Mammary Crests (Ridges) appear during the 4th Week
  2. Crests extend from Axillary Region to Inguinal Region
  3. Usually Disappear - Except in Pectoral Region
  4. Primary Mammary Buds - Secondary Mammary Buds - Lactiferous Ducts and their Branches
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14
Q

What are common Breast Related Symptoms?

A
  1. Gynecomastia - Postnatal Development of Rudimentary Lactiferous Ducts in Males
  2. Extra Breasts / Nipples - Polymastia / Polythelia
  3. Absence of Beast / Nipples - Amastia / Athelia
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15
Q

What is the Blood Supply to the Breast?

A
  1. Thoraco-Acromial Artery
  2. Lateral Thoracic Artery
  3. Internal Mammary (Thoracic) Artery
  4. Branches of the Axillary Artery
  5. Branches of the Internal Thoracic Artery
  6. Branches of some Intercostal Arteries
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16
Q

What is the Nerve Supply of the Breast?

A

Anterior / Lateral Cutaneous Branches of 4th-6th Intercostal Nerves:

  1. Sensory Fibres to the Skin
  2. Sympathetic Fibres to the Blood Vessels / Smooth Muscle around the Nipple
17
Q

What is the significance of the Lymphatic Drainage of the Breast?

A
  1. Metastatic Spread occurs primarily by these Routes
  2. These branch extensively and do not contain valves
  3. Most Lymph = from Lateral Quadrant - Axillary Nodes
  4. Some Lymph drains to the Supraclavicular / Inferior Cervical Nodes
  5. Lymph from the Medial Quadrants drain to the Parasternal Lymph Nodes / Opposite Breast
18
Q

What is the Role of the Sentinel Lymph Node in Breast Cancer?

A
  1. First Draining Node and so should be Biopsied

2. Radio-labelled Colloid is used to locate this

19
Q

What forms the Breast Soft Tissue?

A
  1. Lobes which contain a Network of Glandular Tissue consisting of:
  2. Branching Ducts
  3. Secretory Lobules (in a Connective Tissue Stroma)
20
Q

What is the Terminal Duct Lobular Unit?

A

The Functioning Milk Secretory Component of the Breast

21
Q

What is the difference between the Connective Tissue surrounding the:

  1. Lobular Tissue?
  2. Intralobular Tissue?
A
  1. Dense and Fibrocollagenous

2. Loose Texture

22
Q

What are the Breast Ducts and Acini lined with?

A

2 Layers of Cells:

  1. Luminal Epithelial Cells
  2. Myoepithelial Cells
23
Q

What age related changes occur at

  1. Prepuberty?
  2. Puberty?
  3. Post-Menopause?
A
  1. Slight Enlargement - Growth of Fibrous Stroma / Fat
  2. a) Branching of Lactiferous Ducts
  3. b) Solid Masses of Granular Polyhedral Cells (Alveoli)
  4. c) Accumulation of Lipids in the Adipocytes
  5. a) Progressive Atrophy of Lobules and Ducts
  6. b) Fatty Replacement of Glandular Tissue
24
Q

What happens to the Breasts During Pregnancy?

A
  1. Enlarged Lobules
  2. Dilated Acini
  3. Epithelium vary from Cuboidal to Low Columnar
25
Q

What happens in the Lactating Breast?

A
  1. Acini distended with Milk
  2. Thin Septa between Lobules
  3. Acini with Oesinophilic Material containing Clear Vacuoles
  4. Milk Production
26
Q

What diagnostic Methods are there for Breasts?

A
  1. Imaging - Mammography / Ultrasound
  2. Fine Needle Aspiration Cytology
  3. Core Biopsy
27
Q

What are the Benign Breast Tumours?

A
  1. Fibroadenomas
  2. Duct Papillomas
  3. Adenomas
  4. Connective Tissue Tumour
  5. Paget’s Disease of the Nipple
28
Q

What is Paget’s Disease of the Nipple?

A
  1. Erosion of the Nipple resembling Eczema

2. Associated with Ductal / Invasive Carcinoma