Breast Lecture 1

Question 1

What is the breast?

Answer 1

Highly specialised sweat gland

Question 2

What is the vertical extent of the breast?

Answer 2

2nd/3rd rib to 6th rib

Question 3

What is the transverse extent of the breast?

Answer 3

Sternal edge to midaxillary line

Question 4

The breast lies on top of what?

Answer 4

Deep pectoral fascia

Question 5

The breast covers what muscles?

Answer 5

2/3 Pec major

1/3 Serratus anterior

Question 6

How is the breast attached to the dermis?

Answer 6

Suspensory ligament of cooper

Question 7

How many lobules are contained within the breast?

Answer 7

15-20

Question 8

How are lobules of the breast drained?

Answer 8

Lactiferous duct

Question 9

What is the role of the areola?

Answer 9

Secrete oily material by sebaceous glands for lubrication

Question 10

How is the breast developed in-utero?

Answer 10

Mammary crests appear during week 4

Primary mammary buds

Question 11

What is Gynecomastia?

Answer 11

Postnatal development of rudimentary lactiferous ducts in males
2/3 of males midpuberty

Question 12

What is the blood supply of the breast?

Answer 12

Thoraco acromial artery
Lateral thoracic artery
Internal thoracic artery

Question 13

What is the innervation of the breast?

Answer 13

Anterior + lateral cutaneous branches of 4-6th intercostal nerves
Sympathetic fibres to blood vessels + smooth muscle around the nipple

Question 14

What is the lymphatic drainage of the breast?

Answer 14

Lateral:
>75% axillary lymph nodes
Some drain directly to supraclavicular nodes

Medial:
Parasternal lymph nodes

Question 15

How is the sentinel node located in breast cancer?

Answer 15

Radiolabelled colloid, dye

Question 16

What connective tissue surrounds the lobules?

Answer 16

Dense, fibrocollagenous

Question 17

What connective tissue surrounds the intralobular tissue?

Answer 17

Loose texture

Question 18

Ducts and acini of the breast are lined by what?

Answer 18

Luminal epithelial cells

Myoepithelial cells

Question 19

What breast changes are seen in prepuberty?

Answer 19

Neonatal breasts contain lactiferous ducts but no alveoli

Little branching until puberty

Question 20

What breast changes are seen in puberty?

Answer 20

Branching of lactiferous duct
Solid, spheroidal masses of alveoli
Accumulation of lipids in adipocytes

Question 21

What breast changes are seen in postmenopause?

Answer 21

Progressive atrophy of lobules/ducts

Fatty replacement of glandular tissue

Question 22

What is colostrum?

Answer 22

Protein rich fluid
Available few days after birth
Rich in maternal antibodies

Question 23

How is breast pathology diagnosed?

Answer 23

Mammography
USS
FNAC
Core biopsy

Question 24

Why is breast cancer significant?

Answer 24

20% of cancers in women
Commonest CoD in women 35-55
1 in 9 chance of developing

Question 25

What changes can suggest breast cancer?

Answer 25

Skin dimpling
Abnormal contours
Edema of skin
Nipple retraction

Question 26

What benign tumours are seen in the breast?

Answer 26

Fibroadenomas
Duct papillomas
Adenomas
Connective tissue tumours

Question 27

What is Paget’s disease of the nipple?

Answer 27

Erosion of nipple resembling eczema (unilateral)

Associated with ductal/invasive carcinoma