Breast

Question 1

What is the function of breasts

Answer 1

• Part of reproductive system
• Responds to sexual stimulation and feeds babies
• Exocrine gland – modified apocrine sweat gland

Question 2

What are the steps in lactation

Answer 2

During pregnancy mammary glands expand out due to hormones
Not developed in males
Myoepithelial cells surround mammary glands and contract on mammary glands to squeeze milk out - ejected through nipple though tiny holes (nipple pores)
Areolar contain areolar glands - secrete oily substance called oily substance to moisturise niiple for breastfeeding and act as “target: for baby
Suspension liigaments keep breast anchored to chest wall
When baby suckles, mechanoreceptors activated send messaged to hypothalamus - sends on signals to send oxytocin (from pros pituitary) - and sends off signal to anterior - prolactin
Need both prolactin and oxytocin
Cascade triggered when baby cries

Question 3

When do breasts develop?

Answer 3

• Breast Buds in both sexes 6-9th fetal life
• At puberty female breast develops under influence of oestrogen and progesterone
• Asymmetry is common
• Final maturation during first pregnancy
• Regression following menopause

Question 4

What is accessory breast tissue?

Answer 4

Accessory breast tissue is a relatively common congenital condition in which abnormal accessory breast tissue is seen in addition to the presence of normal breast tissue. This normal variant can present as a mass/nipple anywhere along the course of the embryologic mammary streak (axilla to the inguinal region).

Question 5

Describe breast anatomy

Answer 5

• 2nd-6th rib
• Sternal edge to anterior axillary line
• 15-20 lobes
• Supported by Cooper’s suspensory ligaments

Question 6

What is Peau d’orange

Answer 6

Peau d’orange in breast cancer. Oedema limited at dimples by Coopers ligaments

Question 7

Give some breast cancer facts

Answer 7

• Most Common cancer in Women in UK
• 1 in 8 women
• Over 40,000 cases per year
• Over 10,000 deaths per year
• Screening programme 50-70yrs

Question 8

What increases the risk of breast cancer

Answer 8

• Woman
• Age
• Family History
• Genetics
• Alcohol
• Obesity
• Radiation
• High socioeconomic class

Question 9

What decreases the risk of breast cancer?

Answer 9

• First pregnancy before the age of 30
• Breast feeding
• Exercise
• Healthy organic diet?

Question 10

What are some treatments for breast cancer

Answer 10

Surgery 
• Breast
– Wide Local Excision 
– Mastectomy
• Axilla
– Sample 
– Sentinel lymph node biopsy (SLNB)  
– Axillary dissection / clearance

Adjuvant
• Radiotherapy
• Chemotherapy 
• Hormonal Therapy 
• Monoclonal antibodies

Question 11

Why has there been an improvement in breast cancer survival rates?

Answer 11

• Cultural – patients present earlier
• Screening?
• Team working
• Anti oestrogens (Tamoxifen)
• Other drugs ?

Question 12

What is the breast screening programme

Answer 12

• Launched in 1988
• First of its kind as a National Screening Programme
• 3 yearly cycle
• Initially 50-70 years
• Recent age extension to 47-73