Breast Lecture 1 Flashcards
What is the breast?
Highly specialised sweat gland
What is the vertical extent of the breast?
2nd/3rd rib to 6th rib
What is the transverse extent of the breast?
Sternal edge to midaxillary line
The breast lies on top of what?
Deep pectoral fascia
The breast covers what muscles?
2/3 Pec major
1/3 Serratus anterior
How is the breast attached to the dermis?
Suspensory ligament of cooper
How many lobules are contained within the breast?
15-20
How are lobules of the breast drained?
Lactiferous duct
What is the role of the areola?
Secrete oily material by sebaceous glands for lubrication
How is the breast developed in-utero?
Mammary crests appear during week 4
Primary mammary buds
What is Gynecomastia?
Postnatal development of rudimentary lactiferous ducts in males
2/3 of males midpuberty
What is the blood supply of the breast?
Thoraco acromial artery
Lateral thoracic artery
Internal thoracic artery
What is the innervation of the breast?
Anterior + lateral cutaneous branches of 4-6th intercostal nerves
Sympathetic fibres to blood vessels + smooth muscle around the nipple
What is the lymphatic drainage of the breast?
Lateral:
>75% axillary lymph nodes
Some drain directly to supraclavicular nodes
Medial:
Parasternal lymph nodes
How is the sentinel node located in breast cancer?
Radiolabelled colloid, dye
What connective tissue surrounds the lobules?
Dense, fibrocollagenous
What connective tissue surrounds the intralobular tissue?
Loose texture
Ducts and acini of the breast are lined by what?
Luminal epithelial cells
Myoepithelial cells
What breast changes are seen in prepuberty?
Neonatal breasts contain lactiferous ducts but no alveoli
Little branching until puberty
What breast changes are seen in puberty?
Branching of lactiferous duct
Solid, spheroidal masses of alveoli
Accumulation of lipids in adipocytes
What breast changes are seen in postmenopause?
Progressive atrophy of lobules/ducts
Fatty replacement of glandular tissue
What is colostrum?
Protein rich fluid
Available few days after birth
Rich in maternal antibodies
How is breast pathology diagnosed?
Mammography
USS
FNAC
Core biopsy
Why is breast cancer significant?
20% of cancers in women
Commonest CoD in women 35-55
1 in 9 chance of developing
What changes can suggest breast cancer?
Skin dimpling
Abnormal contours
Edema of skin
Nipple retraction
What benign tumours are seen in the breast?
Fibroadenomas
Duct papillomas
Adenomas
Connective tissue tumours
What is Paget’s disease of the nipple?
Erosion of nipple resembling eczema (unilateral)
Associated with ductal/invasive carcinoma
