Physiology Of The Breast

Question 1

What is the mammary gland comprised of?

Answer 1

• Lactiferous ducts

- Lactiferous sinuses

Question 2

What is the destiny of mammary buds in females?

Answer 2

Form ductal system

Question 3

What is the destiny of mammary buds in males?

Answer 3

Remain underdeveloped because of androgens

- Maternal hormones can cause increase in breast size and milk prod.

Question 4

What is the abnormal milk, produced in the male breast exposed to maternal hormones, called?

Answer 4

Witches milk

Question 5

What physiological change does, the hormone estrogen, cause on breast development?

Answer 5

Ovarian estrogen stimulates proliferation of mammary ducts

- Estrogen Increases cell size

Question 6

What physiological change does, the hormone estrogen, cause on breast development?

Answer 6

Development of lobules and alveoli

- Progesterone indexes the secretory function of the cells

Question 7

What physiological change does, the hormone prolactin, cause on breast development?

Answer 7

Stimulates the production and secretion of breast milk.

Question 8

What physiological change does, the hormone oxytocin, cause on breast development?

Answer 8

Myoepithelial cell contraction

Question 9

What is the function of sebaceous glands of the nipple?

Answer 9

Prevent the nipple from drying out.

Question 10

What hormone stimulates breast growth during puberty?

Answer 10

Ovarian estrogen

Question 11

Name 3 signs of risking estrogen levels:

Answer 11

1. Darkened areola
2. Hardened mass beneath the breast
3. Increase in breast size

Question 12

Which receptors are important to note in the effect of estrogen in ductal proliferation, and breast development.

Answer 12

Prolactin dependent Estrogen receptors

Question 13

What day of the cycle does ovulation take place?

Answer 13

Day 14.

Question 14

What is day 14 of the menstrual cycle and

- Which hormone experiences an increase after day 14?

Answer 14

Ovulation: Egg is released.

- Progesterone is most abundant at this point.

Question 15

Describe hormone levels on day 28:

- How does ones breasts present at said time?

Answer 15

On day 28, estrogen and progesterone are at an all time low

• Menstruation takes place
• Breasts are tender

Question 16

Which days in the menstrual cycle, are most ideal for a breast exam?

Answer 16

Day 4-7

Question 17

Which month of pregnancy does the breast reach it’s full mature functionality?

Answer 17

3rd month

Question 18

Name the 8 hormones that true alveoli (True glandular acini) develop under:
- First 4 are most important.

Answer 18

1. Estradiol
2. Progesterone
3. Thyroid hormone
4. Prolactin
5. Growth hormone
6. Insulin
7. Human placental lactose

Question 19

What hormone is hypothalamically regulatedbincreased by estradiol in pegnancy?

Answer 19

Prolactin

Question 20

What hormone antagonises prolactin ACTION in pregnancy at a prolactin-receptor level ?

Answer 20

Progesterone

Question 21

Name the hormone that antagonises prolactin action:

- Name 3 mechanisms used to antagonize prolactin action

Answer 21

Progesterone

1. Inhibiting up regulation of prolactin receptor
2. Reduce estrogen binding
   
   • ( Note E is hypothalamically responsible for prolactin prod.)
3. Competes for binding at glucocorticoid receptor.

Question 22

When does lactation start?

Answer 22

After birth

- Nipple stimulation and suckling.

Question 23

After birth, there is prolonged prolactin release without progesterone inhibition.
- Give 2 reasons for this.

Answer 23

1. More rapid clearance of progesterone (3-4 days)

2. Slower clearance o prolactin ( +/- 7 days)

Question 24

Name 2 prolactin inhibiting drugs that can be administered to stop lactation.

Answer 24

1. Bromocripine

2. Dopamine

Question 25

Name an alternative way one can stop lactation.

Answer 25

Breast binding - Use ice - Avoid Nipple stimulation

Question 26

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:

Answer 26

Stimulation of the anterior pituitary leads to Prolactin secretion. - Prolactin is responsible for milk production and secretion.

Question 27

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:

Answer 27

Stimulation of the posterior pituitary leads to Oxytocin secretion. - Oxytocin leads to the contraction of myoepithelium in the breast. - Ejecting milk

Question 28

Name 3 conditions that lead to male gynecomstia:

Answer 28

Klienfelters syndrome Anorchia Hypogonadia

Question 29

Name 2 male groups that are usually afflicted with male gynecomastia:

Answer 29

1. 70% of boys at puberty | 2. Men over 50: Andropause

Question 30

Name 6 clinical conditions that can lead to male gynecomastia:

Answer 30

Increased estrogen levels: 1. Testicular/ adenocortical tumors 2. Obesity 3. Hypothyroidism 4. Liver failure 5. Androgen insensitivity 6. XXY

Question 31

Name 2 Estrogen receptor antagonists

Answer 31

Digoxin | Phytoestrogens

Question 32

Name 6 lesions typically found in the terminal duct lobular unit:

Answer 32

``` Sclerosing adenoma Cyst Small duct papilloma Hyperplasia Carcinoma Atypical hyperplasia ```

Question 33

Name 2 lesions that typically form in the lobular stroma:

Answer 33

Fibroadenoma | Phyllodes tumor

Question 34

Name 3 lesions that typically form in the nipple:

Answer 34

1. Recurrent Subareola abscess 2. Ductal ecstasies 3. Pagets disease

Question 35

Name 4 lesions that typically form in the interlobular stroma:

Answer 35

1. Fat necrosis 2. Lipoma 3. Fibrous tumor 4. Sarcoma

Question 36

Name 3 development disorders of the breast:

Answer 36

1. Milk line remnants 2. Accessory fat in the axilla 3. Congenital nipple inversion

Question 37

What is milk line remnants?

Answer 37

Extra breast or nipple from epidermal thickening along the milk line

Question 38

What is accessory axillary breast tissue?

Answer 38

Duct formation continues into the axilla or subcutaneous tissue of the chest wall

Question 39

What is congenital nipple inversion?

Answer 39

Failure of nipple to every in development

Question 40

Name 4 symptoms of breast disease:

Answer 40

1. Lumps 2. Pain 3. Palpable mass 4. Nipple discharge

Question 41

What are 4 main causes of breast lumps:

Answer 41

Fibrocystic changes Benign cysts Firboadenomas Invasive carcinomas

Question 42

What epithelial change is seen in non- proliferation changes of the breast?

Answer 42

Apocrine metaplasia of the epithelial lining