Physiology Of The Breast Flashcards
What is the mammary gland comprised of?
- Lactiferous ducts
- Lactiferous sinuses
What is the destiny of mammary buds in females?
Form ductal system
What is the destiny of mammary buds in males?
Remain underdeveloped because of androgens
- Maternal hormones can cause increase in breast size and milk prod.
What is the abnormal milk, produced in the male breast exposed to maternal hormones, called?
Witches milk
What physiological change does, the hormone estrogen, cause on breast development?
Ovarian estrogen stimulates proliferation of mammary ducts
- Estrogen Increases cell size
What physiological change does, the hormone estrogen, cause on breast development?
Development of lobules and alveoli
- Progesterone indexes the secretory function of the cells
What physiological change does, the hormone prolactin, cause on breast development?
Stimulates the production and secretion of breast milk.
What physiological change does, the hormone oxytocin, cause on breast development?
Myoepithelial cell contraction
What is the function of sebaceous glands of the nipple?
Prevent the nipple from drying out.
What hormone stimulates breast growth during puberty?
Ovarian estrogen
Name 3 signs of risking estrogen levels:
- Darkened areola
- Hardened mass beneath the breast
- Increase in breast size
Which receptors are important to note in the effect of estrogen in ductal proliferation, and breast development.
Prolactin dependent Estrogen receptors
What day of the cycle does ovulation take place?
Day 14.
What is day 14 of the menstrual cycle and
- Which hormone experiences an increase after day 14?
Ovulation: Egg is released.
- Progesterone is most abundant at this point.
Describe hormone levels on day 28:
- How does ones breasts present at said time?
On day 28, estrogen and progesterone are at an all time low
- Menstruation takes place
- Breasts are tender
Which days in the menstrual cycle, are most ideal for a breast exam?
Day 4-7
Which month of pregnancy does the breast reach it’s full mature functionality?
3rd month
Name the 8 hormones that true alveoli (True glandular acini) develop under:
- First 4 are most important.
- Estradiol
- Progesterone
- Thyroid hormone
- Prolactin
- Growth hormone
- Insulin
- Human placental lactose
What hormone is hypothalamically regulatedbincreased by estradiol in pegnancy?
Prolactin
What hormone antagonises prolactin ACTION in pregnancy at a prolactin-receptor level ?
Progesterone
Name the hormone that antagonises prolactin action:
- Name 3 mechanisms used to antagonize prolactin action
Progesterone
- Inhibiting up regulation of prolactin receptor
- Reduce estrogen binding
- ( Note E is hypothalamically responsible for prolactin prod.)
- Competes for binding at glucocorticoid receptor.
When does lactation start?
After birth
- Nipple stimulation and suckling.
After birth, there is prolonged prolactin release without progesterone inhibition.
- Give 2 reasons for this.
- More rapid clearance of progesterone (3-4 days)
2. Slower clearance o prolactin ( +/- 7 days)
Name 2 prolactin inhibiting drugs that can be administered to stop lactation.
- Bromocripine
2. Dopamine
Name an alternative way one can stop lactation.
Breast binding
- Use ice
- Avoid Nipple stimulation
In the case of breast feeding after birth, what hormone is secreted when the anterior pituitary is stimulated?
Mention what the effect of this hormone is, on the breast:
Stimulation of the anterior pituitary leads to Prolactin secretion.
- Prolactin is responsible for milk production and secretion.
In the case of breast feeding after birth, what hormone is secreted when the posterior pituitary is stimulated?
Mention what the effect of this hormone is, on the breast:
Stimulation of the posterior pituitary leads to Oxytocin secretion.
- Oxytocin leads to the contraction of myoepithelium in the breast.
- Ejecting milk
Name 3 conditions that lead to male gynecomstia:
Klienfelters syndrome
Anorchia
Hypogonadia
Name 2 male groups that are usually afflicted with male gynecomastia:
- 70% of boys at puberty
2. Men over 50: Andropause
Name 6 clinical conditions that can lead to male gynecomastia:
Increased estrogen levels:
- Testicular/ adenocortical tumors
- Obesity
- Hypothyroidism
- Liver failure
- Androgen insensitivity
- XXY
Name 2 Estrogen receptor antagonists
Digoxin
Phytoestrogens
Name 6 lesions typically found in the terminal duct lobular unit:
Sclerosing adenoma Cyst Small duct papilloma Hyperplasia Carcinoma Atypical hyperplasia
Name 2 lesions that typically form in the lobular stroma:
Fibroadenoma
Phyllodes tumor
Name 3 lesions that typically form in the nipple:
- Recurrent Subareola abscess
- Ductal ecstasies
- Pagets disease
Name 4 lesions that typically form in the interlobular stroma:
- Fat necrosis
- Lipoma
- Fibrous tumor
- Sarcoma
Name 3 development disorders of the breast:
- Milk line remnants
- Accessory fat in the axilla
- Congenital nipple inversion
What is milk line remnants?
Extra breast or nipple from epidermal thickening along the milk line
What is accessory axillary breast tissue?
Duct formation continues into the axilla or subcutaneous tissue of the chest wall
What is congenital nipple inversion?
Failure of nipple to every in development
Name 4 symptoms of breast disease:
- Lumps
- Pain
- Palpable mass
- Nipple discharge
What are 4 main causes of breast lumps:
Fibrocystic changes
Benign cysts
Firboadenomas
Invasive carcinomas
What epithelial change is seen in non- proliferation changes of the breast?
Apocrine metaplasia of the epithelial lining
