Breast anatomy and histology

Question 1

Breast location

Answer 1

• ribs 2 to 6 along midclavicular line
• transversely from lateral border of sternum to midaxillary line
• toward axillary fossa as an extension of mammary gland: axillary process/tail
• the superolateral quadrant is prolonged towards the axilla along the lower edge of the pec major, may extend through the deep fascia up to the apex of axilla

Question 2

What is retromammary space

Answer 2

• separates muscles from the breast
• made of loose connective tissue
• allows some movement of the breast
• contains lymphatics and small vessels

Question 3

What muscles does the breast overlay

Answer 3

2/3 pec major
1/3 serratus anterior

Question 4

suspensory ligaments

Answer 4

• each mammary gland is firmly attached to underlying skin via suspensory/cooper’s ligaments
• extend from deep fascia to dermis around nipple
• well-developed in upper part of breast
• support the breast tissue maintain its non-ptotic form (prevent drooping)

Question 5

Clinical presentation of changes in suspensory ligaments

Answer 5

dimpling of overlying skin
- cutaneous lymphoedema

Question 6

Breast changes and imagery

Answer 6

• vessels may calcify with age
• ducts may contain secretions and calcification
• fat and connective tissue thicken in response to tumour = contribute to mass

Question 7

Breast quadrants/areas

Answer 7

split into 4 quadrants + central
- superior lateral (includes axillary tail/process)
- superior medial
- inferior medial
- inferior lateral

Question 8

Most common quadrant for malignant tumours

Answer 8

superior lateral (60%)

Question 9

Lymph drain system

Answer 9

nipple -> areola -> mammary glands -> lymphatic plexus

Question 10

where does most lymphatic drainage go

Answer 10

axillary nodes

Question 11

Sentinel lymph node

Answer 11

the first lymph node to which cancer cells are most likely to spread from a primary tumour

Question 12

How to find sentinel lymph node

Answer 12

• radioactive substance/dye injected into tumour
• use a probe to track where substance drains to
• both tumour and sentinel node removed

Question 13

Signs of breast cancer

Answer 13

• skin dimpling
• lump
• change in nipple appearance/pulling of nipple
• changes in skin colour or texture
• clear or bloody nipple discharge

Question 14

interference with lymphatic drainage may cause?

Answer 14

1. axillary venous thrombosis
2. lymphoedema

Question 15

what is axillary venous thrombosis?

Answer 15

obstruction of blood vessel
life threatening

Question 16

lymphoedema

Answer 16

• impaired lymph flow from upper limb to axilla
• excess fluid in subcutaneous tissues
• visual breast changes

Question 17

Breast components

Answer 17

1. adipose tissue
2. glandular tissues
3. lactiferous ducts
4. vascular components, nerves, lymphatic drainage
5. connective tissue: suspensory ligaments

Question 18

how do mammary glands differ from other apocrine sweat glands

Answer 18

no capsule or sheath
develop from ectodermal inversion

Question 19

loc