Normal Anatomy of the Breast Flashcards
1
Q
Development of Breast:
- Mammary crests or ridges appear during _th week
- These crests extend from _______ region to ________ region
- The crests usually _______ except in the _______ region
- Primary mammary buds – Secondary buds – lactiferous ducts and their branches
A
4
axillary
inguinal
disappear
pectoral
2
Q
_________ sexual feature of females
A
Secondary
3
Q
Source of ________ for the neonates
A
nutrition
4
Q
Present in a ________ form in males
A
rudimentary
5
Q
Site of __________ change in as many as 1 in 10 women
A
malignant
6
Q
Breast - What are the General features?
A
- Modified and highly specialized sweat glands
- No special capsule or sheath
- Both Males & females have breasts
- Well developed in females
- Breast size and shape result from genetic,racial, and dietary factors
7
Q
what is the extent of the breast?
A
Extent: Vertical: 2nd or 3rd rib – 6th rib
8
Q
what are the transverse boundaries of the breast?
A
Transverse: Sternal edge to midaxillary line
9
Q
the breast Lies on the ____ _______ _____
A
deep pectoral fascia
10
Q
Axillary tail (of spence) or process – what is it?
A
a small part of breast may extend towards axillary fossa
11
Q
Retromammary space (bursa) – what is it?
A
helps some degree of movement
12
Q
what are the breast relations?
A
- 2/3rd of the breast rests on the pectoral fascia covering pectoralis major
- 1/3rd of the breast rests on the fascia covering serratus anterior
- Firmly attached to the dermis by suspensory ligament of cooper – help support the lobules of the gland
13
Q
Breast strucutre:
what is the nipple?
A
Prominence of the breast
14
Q
Breast strucutre:
what is the areola?
A
Pigmented area around the nipple
15
Q
Breast strucutre:
Each breast contains 15-20 _______ of glandular tissue (_________)
A
lobules
parenchyma
16
Q
Breast strucutre:
Each lobule is drained by a _________ _____ – opens independently on the nippl
A
lactiferous duct
17
Q
Breast strucutre:
Each duct has a dilated portion – what is it called?
A
lactiferous sinus
18
Q
what are the features of a nipple?
A
- No fat or hair
- Contains collagenous dense connective tissue, elastic fibres and bands of smooth muscle (can cause erection of nipple)
- The tips of the nipples are fissured with lactiferous ducts opening into them
- Position : variable or 4th intercostal space
19
Q
what are the features of the areola?
A
- Skin covering the nipple and areola contains numerous sweat & sebaceous glands
- Enlarge during pregnancy
- Oily material secreted by the sebaceous gland provides a protective lubricant for nipple and areola
20
Q
what are the breast quadrants?
A
- For anatomical location and description of pathology (cysts and tumours) the breast is divided into 4 quadrants.
- The axillary tail is an extension of breast tissue in the supero-lateral quadrant
21
Q
what is the male breast like?
A
- Rudimentary throughout life
- Formed by small ducts without lobules or alveoli
- Little supporting fibroadipose tissue
- Temporary enlargement in newborn & during puberty
22
Q
what is gynecomastia?
A
- Postnatal development of rudimentary lactiferous ducts in males
- During midpuberty about 2/3rd of boys develop varying degrees of hyperplasia of the breasts
23
Q
what is Polymastia?
A
an extra breast
24
Q
what is Polythelia?
A
an extra nipple
25
what is Athelia or Amastia?
Absence of nipple or breast
26
what is the blood supply of the breast?
Supplied by Branches of axillary artery, internal thoracic, and some intercostal arteries
* Thoraco acromial artery
* Lateral thoracic artery
* Internal mammary (thoracic) artery
27
what is the nerve supply of the breast?
* Anterior and lateral cutaneous branches of 4-6th intercostal nerves
* They convey sensory fibers to the skin of the breast
* They also carry sympathetic fibres to the blood vessels and to the smooth muscle around the nipple
28
what is the lymphatic drianage of the breast?
* Great clinical significance because metastatic dissemination occurs primarily by the lymphatic routes
* Breast lymphatics branch extensively and do not contain valves
* Most lymph (more than 75%) from lateral quadrants – axillary lymph nodes
* Some lymph may drain directly to supraclavicular or inferior cervical nodes
* Lymph from medial quadrants – parasternal or to opposite breast
29
Role of sentinel lymph node (first draining node) biopsy – Breast Cancer
* Lymphatic mapping & staging of patients
* A radiolabelled colloid is used to locate the sentinel node
* At the time of surgery, a vital blue dye is injected
* Combination of rodioisotope and dye provides most accurate means of localizing the node
Find out if the cancer is in the sential node then you know it is localised and good prognosis
30
Breast Soft Tissue:
* Made up of _____ which contains a network of _______ tissue consisting of branching ducts and secretory lobules in a connective tissue stroma.
* The terminal duct lobular unit is the functional ____ secretory component of the breast
* The connective tissue stroma that surrounds the lobules is _____ and fibrocollagenous, whereas intralobular tissue has a _____ texture
lobes
glandular
milk
dense
loose
31
what is the histology of a normal breast?
* Extensive branching duct system
* Surrounded by dense fibrous interlobular tissue (F) & adipose tissue (A)
* Ducts & acini are lined by two layers of cells – Luminal epithelial cells (E) & myoepithelial cells (M) (Myoepithelial cells are the contracting cells and squeeze secretion from the acini)
32
what happens to breasts pre-puberty?
* Neonatal breast contain lactiferous ducts but no alveoli
* Until puberty, little branching of the ducts occurs
* Slight breast enlargement reflects the growth of fibrous stroma and fat
33
what happens to breasts in puberty?
* Branching of lactiferous ducts
* Solid, spheroidal masses of granular polyhedral cells (alveoli)
* Accumulation of lipids in the adipocytes
34
what happens to breasts postmenopausal?
* Progressive atrophy of lobules and ducts
* Fatty replacement of glandular tissue
35
what are Breast like during pregnancy?
Lo – Lobules
S – Septa
A- Acini
E- Epithelial cells
* Enlarged lobules
* Acini are dilated
* Epithelium vary from cuboidal to low columnar
36
what is the histology of a lactating breast like?
* Acini distended with milk
* Thin septa (S) between the lobules
* At higher magnification (b) – Acini with eosinophilic material containing clear vacuoles
* Milk production – Suckling -Neurohormonal reflex –Prolactin & Oxytocin
37
what are some diagnostic methods?
* Imaging –Mammography and Ultrasound
* Fine needle aspiration cytology
* Core biopsy
38
picture showing abnormal breast
39
how common is breats cancer?
* 20% of all cancers in women
* Commonest cause of death in women in 35-55 age group
* In UK, any woman has a 1in 9 chance of developing breast cancer
40
what are the signs of Breast Cancer (Carcinoma of breast)?
Skin dimpling
Abnormal contours
Edema of skin
Nipple retraction and deciation
41
what are some benign breast tumours?
* Fibroadenomas
* Duct papillomas
* Adenomas
* Connective tissue tumours
Paget’s disease of the nipple: Described by Sir James Paget in 1874
* Erosion of the nipple resembling eczema
* Associated with ductal or invasive carcinoma
