195b - Breast Development, Pregnancy, Lactation Flashcards
Which arteries supply the breast?
- Internal mammary artery
- Lateral thoracic artery
Which arteries are circled in red?
Internal mammary arteries
Which patients should recieve a screening mammogram?
Which patients should recieve a diagnostic mammogram?
- Screening
- Anyone without any symptoms/lumps/concerns
- Diagnostic
- Anyone with symptoms: Pain, lump, discharge, nipple retraction, skin changes
- Anyone with abnormal/inconclusive findings from a screening mammogram
How do estrogen and progeterone affect breast tissue during the menstrual cycle?
- Estrogen -> enlargement of breast ducts
- Progesterone -> growth of breast lobules
If a concerning breast nodule is found on mammogram or ultrasound, what is the next step in management?
Core needle biopsy = most common
- Excisional biopsy only if discordant core biopsy results, or core biopsy inaccessible
- FNA is not recommended
How does suckling affect breast milk secretion?
Not just a negative pressure response!
- -> Increased prolactin
- -> initiation and maintenence of milk production
- -> Stimulates paraventricular and supraoptic nucleus of the hypothalamus
- -> Paraventricular -> increased oxytocin
- -> more milk ejection
When does breast development stop?
When does breast tissue finish maturing?
Development stops ~2 years after menarche
Maturation continues until age 30
Which hormones are important for lactation?
- Prolactin -> milk production
- Oxytocin -> milk ejection
Keep the P’s together, keep the vowels together
- Progesterone, estrogen -> prevent lactation during pregnancy by interfering with prolactin binding to alveolar cells
- Drops during delivery -> lactation
Describe the characteristics of benign nipple discharge
- Bilateral
- Any color except bloody or clear
- Multiductal
List 3 non-hormonal factors that are important for breast development in puberty
- Body fat
- Sleep
- Sunlight
- Vitamin D is important for LH/FSH
Which nerves supply the breast?
-
3rd-6th intercostal supply most of the breast
- Lateral and cutaneous branches
-
Supraclavicular nerve supplies skin of the opper portion
- Anterior cutaneous branches
-
Intercostobrachial nerve supplies the medial aspect of the upper arm
- Lateral cutaneous branch of the 2nd intercostal nerve
How does gaining or losing weight affect breast density?
It doesn’t!
(Even change in body composition/fat mass do not affect breast density)
Which veins drain the breast?
Venous drainage follows arteries, courses towards axilla
Circuous venosis = anastomotic circle under nipple/areola complex
Which lymph nodes drain the breast?
- Axillary lymph nodes (most of the breast)
- Internal mammary lymph nodes (medail aspect of the breast)
When in fetal development do the following occur?
- Breast development begins:
- Breast buds reduced to a single pair:
- Secondary buds develop:
- Areola begins to develop:
- Sweat, sebaceous, apocrine glands develop:
- Breast development begins: 5th week
- Breast buds reduced to a single pair: 7th week
- Secondary buds develop: 20th week
- Areola begins to develop: 20th week
- Sweat, sebaceous, apocrine glands develop: 2nd and 3rd trimester