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Flashcards in breast Deck (27)
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1

structure of the breast

mammary glands are modified sweat glands - in superficial facia anterior to the pectoral muscles and anterior thoracic wall
mammary glands made of ducts and secretory lobules -> 20 lactiferous ducts - open independently onto nipple
connective tissue surround duct and lobules - condenses to form ligaments - continuous with the dermis of the skin and support the breast

2

describe nipple

surrounded by a circular pigmented area of skin - aerola

3

effect of carcinoma on the ligaments

creates tension - pitting

4

main components in breast in non-lactating women

fat

5

main components in breast in lactating women

glandular tissue

6

relations of the breast

lie on deep fascia
connective tissue - retromammary space separates the breast from deep fascia - provides degree of movement

7

base of breast

rib 2-6 to mid axillary line

8

arterial supply of the breast

laterally - axilliary artery: superior thoracic, thoracoacromial, lateral thoracic and subscapular

medially - branch of internal thoracic artery

second to 4th IC artery via branches that perforate thoracic wall and overlying muscle

9

venous drainage of the breast

parallel arteries

eventually drain into axillary, internal thoracic and inter-costal veins

10

innervation of the breast

anterior and lateral cutaneous branches of 2nd and 6thh IC nerves

nipple - innervated by the 4th IC nerve

11

lymphatic drainage of the breasr

75% - laterally and superiorly to the axillary nodes

parasternal nodes - deep to anterior thoracic wall and associated with internal thoracic artery

vessels that follow the lateral branches of the posterior intercostal arteries - connect with intercostal nodes situated near the head and the neck of the ribs

12

drainage of axillary nodes

subclavian trunks

13

drainage of the parasternal nodes

bronchiomediastinal trunks

14

intercostal nodes drainage

thoracic duct or broncomediastinal trunks

15

breast in men

rudimentary
small ducts
composed of cords of cells
don't extend beyond the areola

16

where does breast cancer occur

cells in acini, lactiferous ducts and lobules of the breast

17

how do breast tumours spread

lymph
veins
direct invasion

18

what is peau d'orange

lymph blockage and tumour pull on ligaments = orange peel texture

19

what is cancer en cuirasse

manifestation = hard woody texture

20

Anatomy of breast

under hormonal influence
modified sweat gland
15-20 ductal globular units - drain into main duct
fat interspersed
divided by fibrous septae that radiate from centre outwards - suspensory ligaments of cooper
made of glandular tissue, fat and fibrous tissue
from 2nd - 6th rib space
breast parenchyma extends into anterior axillary fold a axillary tail of spence
upper half of breast contains the most breast tissue
complex network behind the nipple
4-18 ducts open on summit of nipple/areola

21

coopers ligament

connective tissue strands connect anterior and posterior fascial planes
supporting structure
provides shape and consistency of parenchyma
cooper's droop

22

blood supply of breast

branch of lateral thoracic artery, internal thoracic artery, thoracoacromial artery, thoracodorsal artery and intercostal arteries
skin supplied by subdermal plexus - communicates with deep parenchymal vessels
nipple areola - receive branch from internal thoracic artery
dominant blood supply form medial aspect

23

venous drainage of the breast

3 groups veins: perforating branches of internal mammory vein, tributaries of auxillary vein, perforating branch of posterior intercostal veins
in continuity with Batson plexus of veins - posterior
conduit for dissemination of breast cancer to spine, pelvis and elsewhere

24

innervation of the breast

anterolateral and anteromedial branches of thoracic intercostal nerves T3-6
innervation from supraclavicular nerves to upper and lateral parts of breast
nipple - dominant supply from lateral cutaneous branch of T4

25

lymphatic drainage of the breast

predominant lymph supply in the axilla
lymph nodes arranges like a square based pyramid - pectoral, subscapular, humeral, central, apical
pyramid contain cutanius nerve, motor nerve, artery and vein
some lymph drain into interpectoral, deltopectoral, supraclavicular or deep cervical
75% drain into lymphatics in axilla
25% into internal mammary node

26

thoracic nerve

damage causes winging of the scapular
supplies serratus anterior

27

thoracodorsal pedical

nerve runs down with artery and vein
damage causes paralysis of latissimus dorsi