dense irregular to loose irregular - interlobular - dense - intralobular - loose (so they can expand)

superficial - areola and nipple - sensory myoepithelial not innervated - activated by endocrine hormones - oxytocin - milk ejection

Breast Histology, Mammogenesis and Lactation Flashcards by Matt Stanton

mammary gland

branching duct system
glandular epithelium
surrounding myoepithelial cells

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gland of mamma

compound tubulo-alveolar gland
gland elements
duct elements
subQ CT stroma
all line in bed of adipose tissue

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skin of nipple and areola

stratified squamous epithelium, dry

no hair follicles, tall dermal papillae

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melanocytes

darker pigmentation of nipple and areola

increase during pregnancy

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nipple and areola

underlying dense irregular CT
abundant elastic fibers attach to nipples

sebaceous empty on surface and into ducts

numerous meissners and pacinian corpuscles
-2 point sensory input

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ducts of nipple

tubular alveolar duct system
10-25 excretory ducts terminate in nipple
each duct drains individual lobe
ducts expand at nipple - lactiferous sinus

each ductule of system leads to lobule

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lobule

functional unit of gland

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duct epithelium

ductules originate at secretory alveoli

cuboidal to columnar epithelium

also layer of myoepithelial cells

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distal alveolar duct cells

may become secretory

-during lactation

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cells bound by

tight junctions
gap junctions - coordination of contraction
desmosomes

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lactiferous sinus

become reservoir for breast milk

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lactiferous alveoli

clusters surround alveolar ductule
-simple columnar epithelium
rough ER, golgi, secretion granules

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myoepithelial cells

surround alveoli

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stroma

dense irregular to loose irregular

interlobular - dense
intralobular - loose (so they can expand)

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interlobular CT

dense separates lobes and lobules

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intralobular CT

loose
surrounds and separates alveoli
allows expansion

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adipose tissue

source of lipid for milk production

-becomes depleted during lactation

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innervation

superficial - areola and nipple - sensory

myoepithelial not innervated

activated by endocrine hormones
oxytocin - milk ejection

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myoepithelial cell innervation

NOPE!
hormone control
primary - oxytocin

released at childbirth

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mammogenesis

6th week gestation - mammary ridges from ectoderm

development under influence of prenatal estrogen

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pre-pubescent mammary gland

nipple
areola
primitive duct system

same in male and female

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mammary gland at puberty

further grow and branch duct system
elaborates under influence of estrogen

alveoli develop under influence of progesterone

adipose increase
CT proliferation

luteal phase - further duct and alveoli development
-estrogen and progesterone

full mammary development requires other hormones

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estrogen

elaborates duct system

progesterone

elaborates alveoli development

mammogenic

cell proliferation

lactogenic

milk production

galactokinetic

promote contraction of myoepithelial | -milk ejection

galactopoietic

maintain milk production after it has been established

lobuloalveolar growth

``` estrogen progesterone PRL GH cortisol ```

lactogenic hormones

``` PRL hCS cortisol insulin thyroid ``` withdrawal of E and P

galactokinetic homrones

oxytocin little bit vasopresin

galactopoietic hormones

PRL - primary | cortisol

breast cancer

75% have estrogen receptors -may also coexpress progesterone receptors postmenopausal vs. premenopausal Tx differences

postmenopausal

aromatase inhibitor

premenopausal

tamoxifen - breast antagonist

estrogen and progesterone

increase as pregnancy progresses stimulate mammogenesis

prolactin

secreted by anterior pituitary throughout pregnancy mammogenic and lactogenic

hCS and hPL

similar to PRL and GH produced by placenta lactogenic

end of pregnancy

breasts fully developed but milk production suppressed except for small amount of colostrum -inhibited by high E and P during pregnancy

oxytocin

during parturition - uterine contractions -cervical distension positive feedback promotes milk ejection positive feedback - suckling, anticipation of nursing, audiovisual stimuli

four stages of lactation

milk synthesis lactogenesis galactopoiesis milk ejection

milk synthesis

initiated by PRl and hPL - later pregnancy

lactogenesis

after birth by loss of placental steroids

galactopoiesis

maintained by PRL - increases with infant sucking

colostrum

lots of IgG to baby also nutrients, fat, antibodies initial fluid before milk comes in

PRL

maintained at higher levels by suckling

after parturition

drop in estrogen and progesterone PRL has intermittent secretions - pulses -response to suckling

oxytocin source

posterior pituitary

inhibition of oxytocin

negative maternal emotions

suckling reflex

activates afferent - breast - spinal cord - hypothalamus 1 first - inhibition of inhibition - so it inhibits dopamine (which normally (-) PRL) - so we have PRL synthesis 2 also stimulation of oxytocin release 3 also inhibitory of GnRH - decrease FSH and LH - inhibits ovarian cycle - promote amenorrhea during breast feeding

human milk

fats in aqueous solution sugar - lactose protein - lactalbumin and casein K, Ca, Na, Cl, P highest calories

cows milk

3x protein - high casein higher electrolyte concentration harder for newborn to digest - bc of casein high

colostrum

has high cell content | macrophages, neutrophils, lymphocytes

breast milk immunity

IgA WBCs growth factors

benefits of breast feeding

baby - reduced infection, increased grwoth, decreased obesity, positive effect on mental development momma - rapid and sustained weight loss, lactational amenorrhea, psych benefits, cost effective