Breast Anatomy

Cards (15)

  • Surface breast anatomy
    A) Sternal Notch
    B) Sternum
    C) Inframammary fold
    D) Areola
    E) Nipple
    F) Axillary tail
  • Breast anatomy
    A) Lobe
    B) Ductule
    C) Lactiferous sinus
    D) skin
    E) fat
    F) pectoralis minor
    G) lymph node
  • Breast anatomy
    A) rib
    B) pectoralis major
    C) fascia
    D) suspensory ligaments
    E) Nipple
    F) Ampulla
    G) Lobule
  • Blood supply
    • Internal thoracic artery
    • lateral thoracic and thoracoacromial branches
    • lateral mammary branches
    • mammary branches
  • The veins of the breast correspond with the arteries, draining into the axillary and internal thoracic veins
  • Internal thoracic artery (also known as internal mammary artery) - a branch of the subclavian artery. Medial perforators intercostal spaces 2-6.
  • Lateral thoracic and thoracoacromial branches originate from the axillary artery
  • Lateral mammary branches originate from the posterior intercostal arteries (derived from the aorta). they supply the lateral aspect of the breast in the 2nd, 3rd and 4th intercostal spaces
  • Mammary branches originate from the anterior intercostal artery
  • Nerve supply
    • nipple at 4th intercostal space in men. Variable in women. T4 nerve
    • Nerve supply T3 - 5th intercostal: sensory to skin, sympathetic to blood vessels in the breast and smooth muscle in skin and nipple
    • Supraclavicular nerves from cervical plexus to upper and lateral parts
  • Embryology of the breast
    • modified sweat gland 4/40 iu from ectodermal ridge
    • axilla to medial thigh through groin - 'milk line'
    • shortly before birth the invagination everts to form a nipple
    • at puberty alveoli sprout from the ducts, fatty infiltration occurs
    • pregnancy makes alveoli enlarge and in lactation secrete milk
    • at menopause the gland atrophies
  • Congenital problems
    • amastia (poland syndrome, polydactyly)
    • hypoplasia, tuberous breast
    • juvenile hypertrophy
    • accessory tissue/nipple (polythelia)
    • inverted nipples (not acute)
  • Common acquired breast problems
    • breast cancer 1 in 8 (Ductal, Lobular)
    • angiosarcoma (RT induced)
    • FA/Phyliodes
    • Abscess/mastitis
    • Duct ectasia
    • Cysts
    • Hamartoma
    • PASH
    • Fat necrosis
    • B3 lesions
  • Triple assessment
    • describe lump
    • size, quadrant, Skin, Nipple discharge
    • flat of hand, radial or circular, normal breast first
    • axilla - same arm 'shake hands', SCF/ICF
    • Imaging
    • ultrasound
    • MRI
    • Biopsy
    • histology - core or punch
    • cytology FNA or nipple smear
  • Treatment of breast cancer
    • usually surgery first - try to preserve breast
    • mastectomy - consider reconstruction
    • chemotherapy
    • radiotherapy
    • immunotherapy
    • anti-her2 treatments
    • endocrine therapy
    • bisphosphonates