Anatomy and Physiology of the Breast

Question 1

What is the most common and most affective screening tool of breast cancer?

Answer 1

Mammography

Question 2

What is the first imaging sign in mammography of a developing malignancy?

Answer 2

Microcalcifications

Question 3

Match radiopaque and radiolucent with fatty and dense breasts

Answer 3

Dense = radiopaque (x-ray cannot penetrate through)

Fatty = radiolucent

Question 4

T or F? Mammography is good at detecting if a lesion is solid or cystic?

Answer 4

FALSE: cannot be determined which is when they send the patient for an ultrasound

Question 5

Is the breast an endocrine or exocrine gland?

Answer 5

Exocrine

Question 6

What is the primary function of the breast?

Answer 6

To produce milk

Question 7

What elements of the breast tissue primarily function to produce and convey milk?

Answer 7

Glandular tissue

Question 8

What do stromal elements of the breast consist of? (5)

Answer 8

1. CT
2. Fat
3. Blood vessels
4. Lymphatics
5. Nerves

Question 9

Unilateral early ripening or unilateral premature thelarche usually occurs prior to what age?

Answer 9

8 years

Question 10

What is precocious puberty?

Answer 10

Development of both breast by the age of 8

Question 11

What is the most common nipple variant?

Answer 11

Polythelia (accessory nipple)

Question 12

T or F? Congenital nipple inversion is a normal variant?

Answer 12

TRUE

Question 13

What type of glands are found at the areola?

Answer 13

Montgomery glands - secrete oil during breast feeding

Question 14

What arteries supply the medial and lateral part of the breast?

Answer 14

Medial: Internal thoracic artery supply

Lateral: Axilla (lateral thoracic and thoracoacromial artery)

Question 15

What veins drain the breast? (3)

Answer 15

1. Axilla
2. Internal thoracic
3. 2-4th intercostal veins

Question 16

Lymph in the breast flows through the intra-mammary nodes and lymph vessels into what?

Answer 16

Subareolar plexus

Question 17

Where are the intra-mammary nodes of the breast especially located?

Answer 17

UOQ near axilla

Question 18

Are intra-mammary nodes or axillary nodes more commonly seen on ultrasound?

Answer 18

Axillary

Question 19

How big are intra-mammary nodes usually?

Answer 19

< 1cm

Question 20

What nodes account for most of the lymph drainage?

Answer 20

Axillary (lateral pathway)

Question 21

What is the first lymph node which drains a cancerous tumor and is at most risk for metastasis?

Answer 21

Sentinel Lymph Node (SLN)

Question 22

Where is the sentinel lymph node (SLN) located ?

Answer 22

Lower axillary

Question 23

What type of ligament connects the breast to the skin?

Answer 23

Coopers’ ligaments

Question 24

What is another name for the fibrous tissue of the breast?

Answer 24

Suspensory ligaments

Question 25

T or F? Both males and females contain coopers' ligaments in the breast?

Answer 25

FALSE: men do not

Question 26

What provides support to the breast?

Answer 26

Coopers' ligaments

Question 27

Portions of mammary tissue can extend into the axilla, which is called what?

Answer 27

Axillary tail AKA tail of Spence

Question 28

What is the axillary tail also called?

Answer 28

Tail of Spence

Question 29

How many overlapping lobes does the mammary layer consist of?

Answer 29

15-20

Question 30

How many TDLU's are contained in each lobe?

Answer 30

20-40

Question 31

What does a TDLU consist of?

Answer 31

1. Lobule 2. Extralobular terminal duct

Question 32

What are the SMALLEST functional units of the breast?

Answer 32

Acini

Question 33

When do ductules turn into acini or alveoli?

Answer 33

During pregnancy

Question 34

Where does most pathology of the breast arise from?

Answer 34

TDLU's

Question 35

Where are TDLU's most commonly found? (what breast layer)

Answer 35

Mammary

Question 36

What is the pathway of the ductal system from smallest to largest? (6)

Answer 36

Acini --> intralobar terminal duct --> extralobar terminal duct --> lactiferous duct --> lactiferous sinus --> nipple

Question 37

What type of breast tissue is most common in males?

Answer 37

Fatty tissue

Question 38

What are the two most common breast conditions in men?

Answer 38

1. Gynecomastia (benign breast enlargement) 2. Cancer

Question 39

Which breast layer contains fat?

Answer 39

All of them

Question 40

What hormone(s) stimulate stromal & ductal growth and development as well as altering body fat composition?

Answer 40

Estrogen

Question 41

What hormone(s) are responsible for giving the nipple its colour?

Answer 41

Estrogen and progesterone

Question 42

What hormone triggers the growth of alveoli?

Answer 42

Progesterone

Question 43

What hormone stimulates milk production?

Answer 43

Prolactin

Question 44

What hormone triggers milk ejection?

Answer 44

Oxytocin

Question 45

What is the pre-mammary layer also known as?

Answer 45

Subcutaneous fat layer

Question 46

In which layer of the breast are Cooper's ligaments best seen?

Answer 46

Premammary

Question 47

Which breast layer contains the glandular tissue?

Answer 47

Mammary layer

Question 48

Which layer will you see lactiferous ducts?

Answer 48

Mammary layer

Question 49

Where is most glandular tissue found in the breast? (hint: quadrant)

Answer 49

UOQ

Question 50

What is contained in the retro-mammary layer?

Answer 50

Fat and ligaments (suspensory ligaments)

Question 51

Fatty replacement of parenchyma occurs with what factor?

Answer 51

Increasing age

Question 52

A lesion sits at 10:00 in the right breast- which quadrant is the lesion in?

Answer 52

RUO

Question 53

A lesion sits at 7:00 in the left breast- which quadrant is the lesion in?

Answer 53

LLI