195b - Breast Development, Pregnancy, Lactation Flashcards

1
Q

Which arteries supply the breast?

A
  • Internal mammary artery
  • Lateral thoracic artery
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2
Q

Which arteries are circled in red?

A

Internal mammary arteries

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3
Q

Which patients should recieve a screening mammogram?

Which patients should recieve a diagnostic mammogram?

A
  • 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
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4
Q

How do estrogen and progeterone affect breast tissue during the menstrual cycle?

A
  • Estrogen -> enlargement of breast ducts
  • Progesterone -> growth of breast lobules
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5
Q

If a concerning breast nodule is found on mammogram or ultrasound, what is the next step in management?

A

Core needle biopsy = most common

  • Excisional biopsy only if discordant core biopsy results, or core biopsy inaccessible
  • FNA is not recommended
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6
Q

How does suckling affect breast milk secretion?

A

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
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7
Q

When does breast development stop?

When does breast tissue finish maturing?

A

Development stops ~2 years after menarche

Maturation continues until age 30

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8
Q

Which hormones are important for lactation?

A
  • 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
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9
Q

Describe the characteristics of benign nipple discharge

A
  • Bilateral
  • Any color except bloody or clear
  • Multiductal
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10
Q

List 3 non-hormonal factors that are important for breast development in puberty

A
  • Body fat
  • Sleep
  • Sunlight
    • Vitamin D is important for LH/FSH
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11
Q

Which nerves supply the breast?

A
  • 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
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12
Q

How does gaining or losing weight affect breast density?

A

It doesn’t!

(Even change in body composition/fat mass do not affect breast density)

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13
Q

Which veins drain the breast?

A

Venous drainage follows arteries, courses towards axilla

Circuous venosis = anastomotic circle under nipple/areola complex

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14
Q

Which lymph nodes drain the breast?

A
  • Axillary lymph nodes (most of the breast)
  • Internal mammary lymph nodes (medail aspect of the breast)
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15
Q

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:
A
  • 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
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