Normal Anatomy of the Breast Flashcards

1
Q

What factors influence breast size and shape?

A

Genetic
Racial
Dietary

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2
Q

Extent of breast location on ribs

A

2nd/3rd rib to the 6th rib

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3
Q

Transverse location of the breast

A

Sternal edge to the mid axillary line

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4
Q

What does the breast lie on?

A

Deep pectoral fascia

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5
Q

What is the axillary tail (of spence) or process?

A

When a small part of the breast tissue extends towards the axillary fossa

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6
Q

What does 2/3rds of the breast rest on?

A

Pectoral fascia covering the pectoralis major

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7
Q

What does 1/3rd of the breast lie on?

A

The fascia covering the serratus anterior

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8
Q

How is the breast firmly attached to the dermis?

A

By the suspensory ligament of cooper - helps to support the lobules of the gland

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9
Q

What is the nipple?

A

The prominence of the breast

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10
Q

What is the areola?

A

The pigmented area around the nipple

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11
Q

How many lobules of glandular tissue (parenchyma) does each breast contain?

A

15-20

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12
Q

What is the functional unit of the breast?

A

Lobules of glandular tissue

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13
Q

How is each lobule drained?

A

By lactiferous duct - opens independently to the nipple

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14
Q

Function of the lactiferous sinus

A

Dilated position of each duct which, when breastfeeding starts, the milk is transferred from the alveoli into the sinuses and so a small amount is stored in the sinus, so the baby will get milk more easily

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15
Q

Position of the nipple

A

Variable of the 4th intercostal space

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16
Q

What does the nipple contain?

A

Collagenous dense connective tissue
Elastic fibres
Bands of smooth muscle

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17
Q

What does the nipple NOT have?

A

Fat

Hair

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18
Q

What does the areola contain?

A

Numerous sweat glands

Numerous sebaceous glands

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19
Q

Does the areola enlarge during pregnancy?

A

Yes

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20
Q

Function of the sebaceous gland of the areola

A

Oily material is secreted which provides a protective lubricant for the nipple and the areola

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21
Q

4 quadrants of the breast

A

Superomedial quadrant
Inferomedial quadrant
Superolateral quadrant (axillary tail extension of breast tissue in this quadrant)
Inferolateral quadrant

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22
Q

Male breast contains

A

Small ducts without lobules or alveoli

Little supporting adipose tissue

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23
Q

When does the male breast have temporary enlargement?

A

Newborn

During puberty

24
Q

Development stages of the breast

A
  1. Mammary crests or ridges appear during the 4th week
  2. These crests usually disappear except in the pectoral region
  3. Primary mammary buds -> secondary mammary buds -> lactiferous ducts and their branches
25
Gynaecomastia definition
Post natal development of rudimentary lactiferous ducts in males
26
Polymastia definition
An extra breast
27
Polythelia definition
An extra nipple
28
Athelia definition
Absence of a nipple
29
Amastia definition
Absence of a breast
30
Breast blood supply
Branches of the axillary artery, internal thoracic Artery and some intercostal arteries - thoraco-acromial artery - lateral thoracic artery - internal mammary (thoracic) artery
31
Nerve supply to the breast
Anterior and lateral cutaneous branches of the 4th-6th intercostal nerves
32
What do the nerves of the breast supply?
Sensory fibres to the skin of the breast | Sympathetic fibres to the blood vessels and to the smooth muscle around the nipple
33
Do breast lymphatics contain valves?
No
34
Clinical significance of breast lymphatic drainage
Metastatic dissemination occurs primarily by lymphatic routes Spread of infection
35
Where does most of the lymph (>75%) from the lateral quadrants end up?
In the axillary nodes
36
Possible lymphatic drainage of the breast to.....
Axillary nodes Supraclavicular nodes Inferior cervical nodes From medial quadrants - parasternal or opposite breast
37
What lymph node has a role in biopsies for breast cancer?
Sentinel node
38
What is the significance of the sentinel node
It is the first draining node
39
What is the functioning milk secretory component of the breast?
The terminal duct lobular unit
40
What is the breast soft tissue made up from?
Lobes which contain a network of glandular tissue consisting of branching ducts and secretory lobules in a connective tissue stroma
41
Lobular vs intralobular tissue
Lobular tissue = connective tissue stroma that surrounds the lobules is dense and fibrocollagenous Intralobular tissue = loose texture
42
Branching duct system of the breast is surround by two types of tissue
1. dense fibrous interlobular tissue | 2. Adipose tissue
43
Ducts and acini of the breast are lined by two layers of cells
1. luminal epithelial cells | 2. myoepithelial cells
44
Changes to the breast pre-puberty
Neonatal breast contains lactiferous ducts but no alveoli Until puberty, little branching of the ducts occurs Slight breast enlargement reflects the growth of fibrous stoma and fat
45
Changes to the breast during puberty
Branching of lactiferous ducts Solid, spheroidal masses of glandular polyhedral cells/alveoli Accumulation of lipids in the adipocytes
46
Changes to the breast post-menopause
Progressive atrophy of lobules and ducts | Fatty replacement of glandular tissue
47
Histology of the breast during pregnancy shows....
Colostrum - protein rich fluid available a few days after birth
48
What is colostrum rich in?
Maternal antibodies
49
Histology of lactating breast shows.....
Acini distended with milk Thin septa between lobules At high magnification: acini with eosinophilic material containing clear vacuoles Milk production; suckling-neurohormonal reflex -prolactin and oxytocin
50
Diagnostic methods in breast pathology
Mammography USS FNAC Core biopsy
51
Warning signs of breast cancer on the breast
Skin dimpling Abnormal contours Edema of skin (peau d'orange sign) nipple retraction and deviation
52
Pathology of carcinoma in situ of the breast
Cluster of malignant epithelial cells invade into the normal stroma
53
Chance of a woman developing breast cancer
1 in 9/10
54
Benign breast tumours include
Fibroadenoma Duct papilloma Adenoma Connective tissue tumours
55
Definition of Pagets Disease of the nipple
Erosion of the nipple resembling ezcema
56
What is pagents disease of the nipple associated with?
Ductal or invasive carcinoma