Breast Flashcards
Where is the breast tissue found?
In subcutaneous tissue overlying muscles of anterior thoracic wall
What type of gland is breast tissue?
Modified apocrine sweat gland
Where do breasts develop?
Breasts can develop anywhere along the mammary ridge (milk line) which runs from axilla to groin
What is polythelia?
Supernumerary nipples (extra nipples)
What is polymastia?
Accessory breasts (secondary breast may develop)
What factors affect the size/shape of the breasts?
Menstrual cycle / hormones Age & sexual maturity Inherited factors Pregnancy Lactation
What muscles’ fascia does the base of the breast lie anterior to?
Base of breast lies anterior to the fascia of pectorals major and serratus anterior
Where is the base of the breast?
The base of the breast sits over ribs 2-6 and extends from the sternum to the midaxillary line and superolaterally into the axilla (Tail of Spence)
What are Cooper’s ligaments?
Fibrous suspensory ligaments that sit within and support the breast and attach to the dermis.
What is the retromammary space and what is it’s function?
Retromammary space sits between breast tissue and pectoralis fascia. Filled with loose connective tissue and fat and allows free movement of breast.
How do you check clinically if breast movement is independent to pectoralis major movement?
Ask patient to push their hands into hips.
How many lactiferous ducts does the nipple receive?
15-20
What are Montgomery glands?
Sweat and sebaceous glands that open onto areolar
What happens to the areolar during/after pregnancy?
Often darkens
What is the innervation of the breast?
T4-T6 intercostal nerves
What are some non-breast origins of mastalgia (breast pain)?
Cardiac, respiratory, musculoskeletal, infective - shingles
How can the breast be easily anaesthetised?
Local anaesthetic injection into the plane of serratus anterior and the interpectoral plane.
What is the blood supply of the lateral breast?
Lateral mammary branches from the lateral thoracic artery (branch of axillary a) and posterior intercostal arteries
What is the blood supply of the medial breast?
Medial mammary branches from the internal thoracic artery and anterior intercostal arteries
What is the main lymphatic drainage of the nipple, areolar and breast tissue?
- Anterior (pectoral) and central AXILLARY nodes
- Parasternal (internal thoracic) nodes
What are the additional routes of lymphatic drainage?
- Interpectoral (rotter) nodes
- Contralateral parasternal nodes
- Contralateral breast
- Subdiaphragmatic/hepatic nodes
- Inguinal lymph nodes
What is the lymphatic drainage of the the breast SKIN?
Axillary, infraclavicular and deep cervical nodes
What can happen following a mastectomy with axillary lymph node clearance?
Upper limb lymphoedema
Define a gland
A gland is a collection of epithelial cells that secrete substances
What quadrants can the breast be divided into for examination purposes?
Upper outer
Upper inner
Lower outer
Lower inner
What are some common presentations of breast problems/disease?
Pain lump Nipple discharge Nipple inversion Skin changes
What are some observable changes of breast cancer?
Asymmetry
New onset nipple retraction
P’eau d’orange
Dimpling of the skin
What causes nipple retraction in breast cancer?
Cooper’s ligaments are being pulled
What causes p’eau d’orange?
P’eau d’orange is due to oedema and pitting of the skin due to blocked lymph drainage. Cancer has likely affected the lymphatic drainage of the breast.
What causes gynaecomastia?
Normally caused by hormones or being overweight, both of these cause an increase in oestrogen which causes breast tissue to grow.
What is the difference between gynaecomastia and breast cancer in men?
Gynaecomastia is bilateral. Breast cancer is unilateral.
Define gynaecomastia
Gynaecomastia is enlargement of the male breast resulting from proliferation of the glandular component.
