Breast Anatomy & Physiology - Presentation

BREAST: ANATOMY AND PHYSIOLOGY VITAL PROJECT PART B – MODULE 1 – PRESENTATION 1 AIHE RAB Radiology Across Borders Australian Institute of Healthcare Education .org Unrestricted Location ① Modified sweat gland ② Located in superficial fascia of anterior chest wall ③ Tail of Spence - extension of the breast tissue VL into the axilla Axillary tail of Spence ④ Variable in size Ø Age Supernumerary nipples Ø Functional state Ø Arrangement of stromal & parenchymal elements Mammary milk line Ø Increased due to oestrogen during puberty, pregnancy Ø Atrophies after menopause due to decrease in hormonal levels Copyright @ 2012, 2008, 2001, 1995, 1980, 1983, 1978 by Mosby, an imprint of Elsevier Inc. AIHE RAB Radiology Across Borders Australian Institute of Healthcare Education .org Relational Anatomy ① Is anterior to the pectoralis major, serratus and external oblique muscles ② Sternum is medial ③ Axilla is lateral ④ Superior border is at the 2nd and 3rd ribs Body of sternum Site of axillary process (tail) Anterior axillary fold Intermammary cleft Nipple Areola Supernumerary nipple (polythelia) Site of xiphoid Inferior cutaneous process Moore, p 100 crease AIHE RAB Radiology Across Borders Australian Institute of Healthcare Education .org Two Tissue Types ① Stromal Fat & connective tissue help provide • support and structure to the breast Montgomery's Breast tissue is supported by gland Lactiferous • duct suspensory ligaments of Cooper Subcutaneous fat (Cooper’s ligaments) Cooper's ligament Cooper’s ligaments run between the • Retromammary lobules from deep muscle fascia to layer Pectoralis major skin surface AIHE RAB Radiology Across Borders Australian Institute of Healthcare Education .org Two Tissue Types ② Parenchymal Lobes, lobules, ducts, acini • Ø15-20 mammary lobes separated by adipose tissue ØEach lobe has external drainage pathways into the nipple ØFurther divided into lobules which contain alveoli (glandular elements which are grape like clusters which secrete the milk) ØEach lobule has up to 100 acini which drain into a collecting duct AIHE RAB Radiology Across Borders Australian Institute of Healthcare Education .org ØDucts drain into the nipple Rib Lobe Adipose tissue ØEach lobe has its own pathway Lobule to the nipple Intercostal muscles Lactiferous duct Pectoralis major Deep fascia Ampulla Mammary Secondary duct tubules AIHE RAB Radiology Across Borders Australian Institute of Healthcare Education .org Three Layers ① Subcutaneous ØThin layer ØFatty tissue ØCooper ligaments Moore, p 100 Chest wall Terminal ductal lobular unit (TDLU) Acini Glandular tissue Pectoralis fascia Fat Dense connective tissue Loose connective tissue Cooper's ligament Ducts Ribs Pectoralis major muscle Nipple Retromammary Major duct layer Duct orifice Subcutaneous fat Nipple Muscles Rib Areola Cooper's ligaments Subcutaneous layer AIHE RAB Radiology Across Borders Australian Institute of Healthcare Education .org ② Mammary (Glandular) Functional portion of the breast Ø15 – 20 lobules Chest wall Terminal ductal lobular unit (TDLU) ØLactiferous ducts Acini Pectoralis fascia Fat Dense connective tissue Exit at nipple Loose connective tissue • Pectoralis major Cooper's ligament ØTerminal ductal lobar unit (TDLU) muscle Retromammary Major duct ØFatty tissue interspersed between layer Duct orifice Nipple lobes Rib Areola ØCooper ligaments Cooper's ligaments Subcutaneous layer Moore, p 100 AIHE ROB Radiology Across Borders Australian Institute of Healthcare Education .org ③ Retromammary ØThin layer Chest wall Terminal ductal lobular unit (TDLU) ØFatty tissue Acini Pectoralis fascia Fat Dense connective tissue Loose connective tissue ØCooper ligaments Pectoralis major Cooper's ligament ØPectoralis major muscle muscle Retromammary Major duct ØPectoralis minor muscle layer Duct orifice Nipple ØRibs Rib_ Areola Cooper's ligaments ØChest wall Subcutaneous layer AIHE RAB Radiology Across Borders Australian Institute of Healthcare Education .org Vascular Supply Arteries Subclavian a .- ØInternal Mammary Thoraco-acromial trunk (internal thoracic) Axillary a. Internal thoracic a. and its ØLateral Thoracic Brachial a. perforating branches Lateral thoracic a. Medial mammary Lateral mammary branches ØLateral Mammary branches Lateral mammary branches of lateral cutaneous branches of posterior intercostal aa. AIHE RAB Radiology Across Borders Australian Institute of Healthcare Education .org Vascular Supply Veins Internal jugular v. Subclavian v .- ØMedial Mammary Cephalic v. ØLateral Mammary Axillary v. ØInternal Thoracic Lateral thoracic v. ØLateral Thoracic Internal thoracic v. and its perforating branches Lateral mammary v. Medial mammary v. AIHE RAB Radiology Across Borders Australian Institute of Healthcare Education .org Lymphatic System ØGenerally to the axillary lymph *Central nodes *Apical nodes Clavicular (supraclavicular and infraclavicular) nodes nodes Internal jugular vein ØLarge majority of lymph is moved Right jugular lymphatic trunk Right lymphatic duct by the axillary chain Subclavian *Humeral vein Right brachiocephalic vein nodes Right bronchomediastina lymphatic trunk Subscapular Right subclavian nodes lymphatic trunk *Pectoral nodes Axillary lymph nodes (B) Pattern of lymphatic drainage of axillary lymph nodes AIHE RAB Radiology Across Borders Australian Institute of Healthcare Education .org Why is Lymphatic Drainage Important? ① Most breast tumours can infiltrate and spread via the axillary lymph nodes ② Surgical therapy of invasive breast cancer involves axillary lymph node dissection Normal Lymph Node Appearance DREAST LYMPH NODE AIHE RAB Radiology Across Borders Australian Institute of Healthcare Education .org Main Function (Physiology) ① Fluid transport & production and secretion of milk ② Ductal system transports the fluids within the breast ③ Affected by changing hormonal levels during each menstrual cycle, pregnancy & lactation AIHE RAB Radiology Across Borders Australian Institute of Healthcare Education .org Disclaimer All information provided by Radiology Across Borders is of general educational nature and does not consider the specific context of a particular patient case. Any information in this presentation is not intended as medical advice used in the diagnosis or treatment of a particular patient. Although we take all reasonable steps to provide accurate and evidence-based information, Radiology Across Borders cannot provide any warranties in relation to the contents of this presentation. Any questions? Contact us at info@radiologyacrossborders.org AIHE RAB Radiology Across Borders Australian Institute of Healthcare Education .org