Anatomy & Histology of Breast

Question 1

What is the structure of the secretory tissue of the breast ?

Answer 1

• made up of 15-25 lobes

- each contains tubulo-acinar gland which drains via ducts to nipple

Question 2

How is the fibrous tissue and adipose tissue related to the secretory tissue of a non-lactating breast?

Answer 2

• adjacent to the secretory lobules is DENSE fibrous tissue

- this is in turn surrounded by adipose tissue

Question 3

What are the suspensory ligaments?

Answer 3

large condensations that extend from the dermis of the skin to the DEEP fascia overlying the muscle of the chest
–supports the breast

Question 4

Describe the terminal duct lobular unit. (TDLU)

Answer 4

• terminal ductules that lead into an INTRALOBULAR collecting duct >lactiferous duct for that lobe> NIPPLE

Question 5

What is the TDLU?

Answer 5

• basic functional secretory unit

Question 6

What does the loose connective tissue of the breast allow?

Answer 6

proliferation of the breast tissue

Question 7

What does the breast acini consist of?

Answer 7

• secretory, epithelial cells

- surrounded by myoepithelial cells

Question 8

Role of the myoepithelial cells surrounding the secretory cells?

Answer 8

contractile properties allows EJECTION of breast milk

Question 9

What are the larger ducts (lactiferous ducts lined by)?

Answer 9

stratified cuboidal/ squamous

Question 10

What form of glands are the mammary glands likened to ?

Answer 10

• sweat glands

Question 11

What is the nipple covered by?

Answer 11

• thin
• highly pigmented
• keratinized stratified squamous epithelium

Question 12

How does the lining of the ducts change as one goes deeper ?

Answer 12

• duct approaching the surface= stratified SQUAMOUS epithelium
• deeper= stratified cuboidal epithelium

Question 13

What form of glands are found directly on the surface of the skin?

Answer 13

• sebaceous glands

Question 14

What changes of the breast tissue occur during the LUTEAL phase (after ovulation)?

Answer 14

• increase in HEIGHT of epithelial cells
• lumina enlarges
• small amounts of secretions appear in ducts

Question 15

What breast tissue changes are seen in the first trimester?

Answer 15

• elongation and branching of SMALLER ducts

- prolif. of epithelial and myoepithelial cells

Question 16

Changes seen in the 2nd trimester?

Answer 16

• differentiation of secretory alveoli

- plasma cells and lymphocytes infiltrate nearby connective tissue

Question 17

Changes seen in the 3rd trimester.

Answer 17

• SECRETORY alveoli continue to mature
• extensive rER develop
• all in all: reduction in connective tissue and adipose tissue

Question 18

What stimulates the proli. of secretory tissue?

Answer 18

• estrogen and progesterone during pregnancy

Question 19

What do the plasma cells produce?

Answer 19

IgA

- for it to be released in to the colostrum

Question 20

How are lipid droplets secreted (for it to be incorporated in the milk) ?

Answer 20

• APOCRINE secretion

- –the droplets are surrounded by membrane and a small amount of cytoplasm

Question 21

How are the proteins released?

Answer 21

• after being produced by the rER
• — secreted via VESICLES (which merge with the APICAL membrane; releasing only their CONTENTS in to the duct system
• by MEROCRINE secretion aka exocytosis

Question 22

How does the breast tissue appear in MENOPAUSE?

Answer 22

• secretory cells degenrate
• fewer fibroblasts in connective tissue
• less collagen and elastic fibres

Question 23

iMMEDIATE MANAGEMENT for migraine include?

Answer 23

1. offer simple analgesia
2. offer triptans ALONE or with PCM (or another NSAID)
   - —sumatriptan is FIRST line
3. offer anti-emetic even in the absence of N &V