BREAST- INTRODUCTION, NORMAL ANA and PHYSIO Flashcards
What are the lesions found in terminal duct lobar unit?
- cyst
- adenosis
- small duct papilloma
- hyprplasia
- atypical hyperplasia
- carcioma
What are the lesions found in lobular stroma?
Fibroademona
phylloides tumor
What are the lesions in large duct and lactiferous sinuses?
- Duct ectasia
- Recurrent subareolar abscess
- Solitary ductal papilloma
- paget disease
What are the lesions on Interlobular stroma ?
- Fat necrosis
- Lipoma
- Fibrous tumor
- Fibromatosis
- Sarcoma
The human
breast contains_________ major ductal systems
six to ten
Normal Breast Anatomy
The keratinizing squamous epithelium of the
overlying skin dips into the orifices at the nipple and then abruptly changes to a
►
double-layered
cuboidal epithelium lining the ducts.
►
Successive branching of the large ducts eventually leads to
►
the terminal duct lobular unit.
NOTE : In adult women the terminal duct branches into a grapelike cluster
of small acini to form a lobule ( Figs. 23-1 and 23-2B ).
- *Each ductal system** typically occupies
- *more than one quadrant of the breast**, and the systems extensively overlap one another. In
- *Mammograms in young women** are typically** _____________**, making mass-forming lesions or calcifications (which are also
radiodense) difficult to detect. B
radiodense
or white in appearance
The density of a young woman’s breast stems from the
_____________________
predominance of fibrous interlobular stroma and the paucity of adipose tissue.
Before
pregnancythelobules are smalland areinvested by loose cellular intralobular stroma.
Larger ducts connect lobules
What is the appearance of the breast during pregnancy?
- branching of terminal ducts produces
- more numerous, larger lobules.
- Luminal cells within lobules undergo lactational change, precursor to milk formation.
With increasing age what happens to the lobules
** decrease in size and number,**
and the interlobular stroma is replaced by adipose tissue.
What is the appearance now of Mammograms in older women?
become more
radiolucent with age as a result of the increase in adipose tissue, which facilitates the
detection of radiodense mass-forming lesions and calcifications.
Two cell types line the ducts and lobules.
- Contractile myoepithelial cells
- . Luminal epithelial cells
- Contractile myoepithelial cells
- . Luminal epithelial cells
_______________containing myofilaments
lie in a meshlike pattern on the basement membrane.
These cells assist in milk ejection during
lactation and provide structural support to the lobules.
Contractile myoepithelial cells
_____________overlay the
myoepithelial cells.
**Luminal epithelial cells **
Only the _____________ are capable of producing milk.
lobular luminal cells
A committed
stem cell is located in the _________ that is postulated to give rise to both luminal and myoepithelial cells
terminal duct
There are also two types of breast stroma.
- interlobular stroma ( Latin. IN BETWEEN)
- intralobular stroma
- interlobular stroma
- intralobular stroma
The interlobular stroma consists of_______________
** dense fibrous **connective tissue
admixed with adipose tissue.
The intralobular stroma envelopes the acini of
the lobules and consists of breast-specific hormonally responsive fibroblast-like cells admixed
with _____________.
NOTE : There is important cross-talk between breast epithelium and stroma
that promotes the normal structure and function of the breast
scattered lymphocytes
In the prepubertal breast in males and females, the large duct system ends in terminal ducts with minimal lobule formation.
Changes in the breast are most dynamic and profound during the reproductive years ( Fig. 23-2 ).
Just as the endometrium grows and ebbs with each menstrual cycle, so does the breast. [3]
What are the changes of the breast during menstrual cycle?
- In the first half of the menstrual cycle the lobules are relatively quiescent.
- After ovulation, under the influence of estrogen and rising progesterone levels, cell proliferation increases, as does the number of acini per lobule.
- The intralobular stroma also becomes markedly edematous.
- Upon menstruation, the fall in estrogen and progesterone levels induces the regression of the lobules and the disappearance of the stromal edema.
Only with the onset of__________ does the breast become completely mature and functional.
Lobules increase progressively in number and size. As a consequence.
pregnancy
by the end of the
pregnancy the breast is _______________
composed almost entirely of lobules separated by relatively scant
stroma
Immediately after delivery of the baby the luminal cells of the lobules produce_________________ over the next 10 days as
progesterone levels drop.
Not surprisingly, given these profound morphologic changes, the
terminally differentiated breast has a specific pattern of gene expression.
- colostrum (high in
protein) **,
- colostrum (high in
which changes to milk (higher in fat and calories)
When does colostrum changes into milk?
10 days
What is the content of colostrum?
HIGH IN PROTEIN
While milk content is?
FAt and calories
What is the function of the breast milk
- provides complete nourishment from birth until several years of age
- also provides protection against infection, allergies, and some autoimmune diseases. Maternal antibodies (chiefly secretory IgA), vitamins, enzymes, and numerous other mediators (e.g., cytokines, antioxidants, fibronectin, and lysozyme) augment the infant’s own developing immune defenses.
Note : However, certain drugs, radioactive compounds given during diagnostic procedures, and viruses can also be passed to the infant through breast milk.
Upon the cessation of lactation, the breast epithelium and stroma undergo extensive
remodeling. What happens?
- Epithelial cells undergo apoptosis,
- lobules regress and atrophy, and the
- totalbreast size is diminished
NOTE ***. However, full regression does not occur, and as a result pregnancy
causes a permanent increase in the size and number of lobules.
After the third decade, long before menopause what happens to the breast?
lobules and their specialized stroma start to involute.
Lobular atrophy may be almost complete in elderly females ( Fig. 23-2D ).
The interlobular stroma also changes, since the radiodense fibrous stroma of the young female (see Fig. 23-2A ) is progressively replaced by radiolucent adipose tissue
