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Endo/Repro > Histophysiology of the mammary gland > Flashcards

Histophysiology of the mammary gland Flashcards

1
Q

Mammary glands are highly modified tubuloalveolar apocrine sweat glands. What are the two main structural components?

A

Breast lobe

Interlobar tissue

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2
Q

The breast lobe is compsed of 15-25 compound tubule-acinar glands of variable size. What do you find in each lobe?

A
  1. Lobules
  2. Terminal ducts
  3. lactiferous ducts
  4. lactiferous sinus
  5. intralobular stroma
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3
Q

What do terminal ducts do?

A

drain each lobule

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4
Q

What do lactiferous ducts do?

A

Drain terminal ducts

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5
Q

What is the lactiferous sinus?

A

•dilation in the duct immediately before the opening

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6
Q

What is interlobular tissue composed of?

A

–Dense regular CT and adipose tissue

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7
Q

What is the structure of the terminal duct unit like? What is it composed of?

A

–Grapelike cluster of alveoli with terminal ducts and intralobular stroma
–Connective tissue
•Loose, collagen rich with dispersed adipose cells

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8
Q

What are the main cells of the TDLU?

A

•Luminal epithelial cells
–Columnar to cuboidal
•Myoepithelial cells
–Flattened, basal

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9
Q

How can you identify inactive breast tissue?

A

IS largely connective tissue

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10
Q

Is this active or inactive breast tissue?

A

Active

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11
Q

Active or inactive?

A

Inactive

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12
Q

Describe inactive mammary gland tissue

A
  • Stroma constitute the major portion of lobules
  • Luminal epithelium columnar, dispersed chromatin
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13
Q

What do we see in active mammary glands? What constitutes the major portion of the lobules?

A
  • Proliferation of the duct system
  • Alveoli constitute the major portion of lobules
  • Luminal epithelium cuboidal, pale cytoplasm, prominent nucleoli
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14
Q

What are the four structures of the nipple?

A
  1. –Areola
  2. –Areolar sebaceous glands
  3. –Lactiferous ducts
  4. –Bundles of smooth muscle
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15
Q

What are the components of the areola?

A
  • Pigmented skin (melanocytes)
  • Stratified squamous keratinized epithelium
  • Dermal papillae
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16
Q

Describe the cell types of the following:

  • From the lactiferous duct
  • Within the lactiferous duct
  • Near duct opening
A

•From the lactiferous duct
–Single layer of columnar or cuboidal

•Within the lactiferous duct
–Stratified cuboidal

•Near duct opening
–Stratified squamous keratinized epithelium

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17
Q

How are the smooth muscle bundles arranged in the nipple?

A
  • Arranged radially and circumferentially in CT
  • Arranged longitudinally around lactiferous ducts
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18
Q

What are the majority of breast cancers?

A

–80% are invasive ductal carcinoma

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19
Q

What do carcinomas arise from?

A

–Ductal
»Within the duct
–Lobular
»Within the terminal acini

20
Q

What is this?

A

An in situe (not yet invaded surrounding tissues) ductal carcinoma

21
Q

What do we have here?

A

Invasive ductal carcinoma

22
Q

What do sarcomas arise from?

A

stroma

23
Q

What are the receptors that determine responsiveness to therapeutic intervention in breast cancer?

A
  • Estrogen-receptor positive (ER+)
  • Human epidermal growth factor expression (HER-2/neu+)
  • Progesterone-receptor positive (PR+)
24
Q

Primary ductal carcinomas are highly mitogenic, and are hormonally responsive. What hormone do they primarily respond to?

A

Estrogen

25
Q

What does CYP19 aromatase inhibitor do?

A

Inhibits peripheral conversion: androgen –> estrogen

(postmenopausal)

26
Q

What are the 4 major mammogenic and lactogenic hormones?

A

Estrogen

progesterone

prolactin

hCS/hPL

27
Q

Near end of pregnancy: breasts are fully developed but milk production is suppressed except for small amount of colostrum. What is this inhibited by?

A
  • Inhibited by high estrogen & progesterone during pregnancy
28
Q

What is the major galactokinetic hormone (milk ejector)? How does it do this?

A

Oxytocin

•Promotes contraction of myoepithelial cells resulting in milk ejection (“let-down”)

29
Q

What is the release and synthesis of oxytocin stimulated by?

A

•positive feedback caused by suckling, anticipation of nursing, and audiovisual stimuli

30
Q

What are the four (more like 3 really) stages of lactation?

A
  1. Milk synthesis
  2. lactogenesis
  3. galactopoiesis
  4. milk ejection
31
Q

What initiates milk synthesis?

A

Initiated after birth by the loss of placental steroids

32
Q

What controls galactopoiesis (maintenance of lactation)

A

Mainly controlled by PRL which is increased by infant suckling

33
Q

Initiation of lactation requires the coordinated action of what stimuli?

A
  • ↑ Prolactin
  • ↓ Estrogen and Progesterone
  • ↑ Oxytocin
  • Suckling
34
Q

What is colostrum?

A
  • thin, yellowish milk-like substance secreted first few days after parturition. High concentration of immunoglobulins.
  • high in nutrients, fats, and antibodies to protect the newborn from infection
35
Q

What can inhibit oxytocin secretion and suppress milk ejection reflex?

A

Negative maternal emotions (frustration, anger, anxiety)

36
Q

What are the four steps of the suckling reflex?

A
  1. Suckling stimulus
  2. Inhibition of Inhibition
  3. Stimulates hypothalamic oxytocin production & release from posterior pituitary
  4. Inhibits hypothalamic production of GnRH
37
Q

What pathway is activated by suckling?

A

Activates afferent neural pathway. Breast –> spinal cord –> hypothalamus

38
Q

Explain step two of the suckling reflex: inhibition of inhibition.

A

Inhibition of Dopamine (Prolactin Inhibitory Factor, PIF) from the hypothalamus

Removes inhibition of lactotrophs –> ↑prolactin –> milk production

39
Q

What does step 3 of the suckling reflex: hypothalamic oxytocin production & release from posterior pituitary, lead to?

A

Activates receptors on breast myoepithelial cells –> milk “let-down”

40
Q

Step four of the suckling reflex Inhibits hypothalamic production of GnRH results in?

A

Results in ↓ LH and FSH, inhibition of ovarian cycle

41
Q

Describe the composition of human milk

A

emulsion of fats in an aqueous solution containing sugar (lactose), proteins (lactalbumin and casein), and K+, Ca2+ , Na+, Cl- and phosphate.

42
Q

How is cow’s milk different from human milk?

A

nearly three times more protein than human milk due to high casein content and higher electrolyte concentration.

43
Q

What agents does breast milk contain to protect the infant?

A
  • Secretory IgA
  • WBCs: neutrophils and macrophages
  • Growth factors: EGF (epidermal growth factor), NFG (nerve growth factor), IGF (insulin-like growth factor)
44
Q

What are the benefits of breast feeding to the infant? (4)

A

–Reduction in infections
•Secretory IgA
–Initial increased growth
–Decreased obesity in adulthood
–Positive effects on mental development

45
Q

What are four benefits of breast feeding to the mother?

A

–More rapid and sustained weight loss
–Lactational amenorrhea
–Psychological benefits
–Cost effective

Endo/Repro (19 decks)

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