Normal Breast Anatomy Lecture Flashcards

1
Q

What is the main function of the breasts?

A

Secondary sexual feature

Source of nutrition for neonates

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2
Q

What are the general features of the breasts?

A

Modified and highly specialised sweat glands
No special capsule or sheath
Present in both genders
Well developed in females
Breast size and shape results from genetic, racial and dietary factors

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3
Q

What is the extent of the breasts both vertically and transversely?

A

Vertically - 2nd/3rd to 6th ribs

Transversely - Sternal edge to midaxillary line

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4
Q

What is the function of the retromammary bursa?

A

Helps some degree of movement of the breast

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5
Q

What is the axillary tail/process?

A

A small part of the breast that may extend to the axillary fossa

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6
Q

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

A

The pectoral fascia which covers the pectoralis major

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7
Q

What does 1/3rd of the breast rest upon?

A

The fascia covering the serratus anterior

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8
Q

How is the breast attached to the dermis?

A

Suspensory ligament of cooper which 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 surrounding 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

How is each lobule drained?

A

Each lobule has a lactiferous duct which opens independently on the nipple

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13
Q

What is the dilated portion of the lactiferous duct called?

A

The lactiferous sinus

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14
Q

What are the 4 breast quadrants?

A

Superolateral quadrant
Superomedial quadrant
Inferolateral quadrant
Inferomedial quadrant

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15
Q

What is the axillary tail an extension of?

A

The superolateral quadrant

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16
Q

What are the characteristics of the male breast?

A

Rudimentary throughout life
Formed by small ducts without lobules or alveoli
Little supporting fibroadipose tissue
Temporary enlargement in newborn and during puberty

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17
Q

Explain the early development of the breast?

A

Mammary crests appear during 4th week
Crests extend from the axillary region to the inguinal region
The crests usually disappear except in the pectoral region
Primary mammary buds -> Secondary buds -> Lactiferous ducts and their branches

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18
Q

What is gynaecomastia?

A

Postnatal development of rudimentary lactiferous ducts in males
During midpuberty about 2/3rd of boys develop varying degrees of hyperplasia of the breasts

19
Q

What is aphelia?

A

Absence of the nipple

20
Q

What is amastia?

A

Absence of the breast

21
Q

What is polymastia?

A

An extra breast

22
Q

What is polythelia?

A

An extra nipple

23
Q

What supplies blood to the breasts?

A

Branches of the axillary artery, internal thoracic and some intercostal arteries

Thoraco-acromial artery
Lateral thoracic artery
Internal mammary (thoracic) artery

24
Q

What nerves supply the breast?

A

Anterior and lateral cutaneous branches 4-6th intercostal nerves

Convey sensory fibres to the skin of the breast
Also carry sympathetic fibres to the blood vessels and to the smooth muscle around the nipple

25
Q

What is the clinical significance of the lymphatic drainage of the breast?

A

Great clinical significance because metastatic dissemination occurs primarily by the lymphatic routes
Breast lymphatics branch extensively and do not contain valves

26
Q

Which lymph nodes drains more than 75% of the lymphatic fluid from the lateral quadrants of the breast?

A

Axillary lymph nodes

27
Q

Where does the other lymphatic fluid drain to from the breast?

A

Supraclavicular or inferior cervical nodes

28
Q

Where does the lymph from the medial quadrants of the breast drain?

A

Parasternal lymph nodes or to other breast

29
Q

What is the role of the sentinel node biopsy?

A

Lymphatic mapping and staging of patients

30
Q

What is used to locate the sentinel node?

A

A radiolabelled colloid and dye

31
Q

What makes up the soft tissue of the breast?

A

Lobes containing a network of glandular tissue consisting of branching ducts and secretory lobules in a connective tissue stroma

32
Q

What is function of the terminal duct lobular unit?

A

It is the functional milk secretory component of the breast

33
Q

What type of connective tissue is the stroma that surrounds the lobules?

A

Dense and fibrocartilagenous

34
Q

What is the texture of interlobular tissue?

A

Loose (it’s lit)

35
Q

What are the histological characteristics of breast tissue?

A

Extensive branching duct system surrounded by dense fibrous interlobular tissue and adipose

Ducts and acini cells are lined by two layers of cells - luminal epithelial cells and myoepithelial cells

36
Q

What changes happen to the breasts before puberty?

A

The neonatal breast contains lactiferous ducts but no alveoli
Until puberty little branching of the ducts occur
Slight breast enlargement reflects the growth of fibrous stroma and fat

37
Q

What changes happen to the breasts during puberty?

A

Branching of the lactiferous ducts
Solid, spheroidal masses of granular polyhedral cells
Accumulation of lipids in the adipocytes

38
Q

What changes happen to the breasts post-menopausally?

A

Progressive atrophy of lobules and ducts

Fatty replacement of glandular tissue

39
Q

What histological characteristics are evident in breast tissue during pregnancy?

A

Enlarged lobules
Acini are dilated
Epithelium vary from cuboidal to low columnar

40
Q

What is colostrum?

A

Protein rich fluid available a few days after birth - rich in maternal antibodies

41
Q

What are the histological characteristics in breast tissue during lactation?

A

Acini are distended with milk
Thin septa are visible between lobules
At higher magnification acini can be seen with eosinophilic material containing clear vacuoles
Milk production happens in response to suckling which causes a neurohormonal reflex

42
Q

What diagnostic methods can be used to examine the breasts?

A

Imaging - mammography, ultrasound
Fine needle aspiration cytology
Core biopsy

43
Q

What are the signs of breast cancer that would be picked up on inspection of the breast?

A

Skin dimpling
Abnormal contours
Oedema of the skin
Nipple retraction