BREAST ANATOMY

Highlights :

BREAST ANATOMY

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Friday, 11 December 2009 06:54

BREAST ANATOMY
* Gross anatomy: "Fibrofatty-granular structure"
Breast
Lobe

Nipple
Areola Lobe
Mammary duct

Lobule
Lobule
Acinus

Collecting duct Acinus
Terminal duct
Schematic anatomy of the breast
 It consists of:
a) Skin: including the nipple and areola.
b) Fat: in which mammary glands are embedded.
c) Mammary glands: which consists of many acini and ducts.
* The acini collected together forming lobules which collected together to form lobes (18-20 lobes).
* Each lobe has a duct called lactiferous duct.
* The lactiferous ducts open separately in the nipple.
* Extensions:
1- Vertically: from the 2nd to the 6th ribs.
2- Horizontally: from margin of the sternum to mid axillary line.
Pectoralis major

Serratus anterior
& external oblique
Underlying muscles Suspensory ligaments of Cooper
3- The whole breast glands lies in the superficial fascia except small part which pass through the axillary fascia to reach the axilla called the axillary tail of Spence.
* Suspensory Ligaments of Cooper:
• The lobes of the breast are suspended in the fatty tissue by fibrous strands which extends from the breast skin to pectoral fascia. "suspensory ligaments of Cooper"
* Underlying Muscles:
1- Pectoralis major m. "Inner 2/3"
2- Serratus ant. and ext. oblique. "lower outer 1/3"
* Arterial supply:
1- Branches from lat. thoracic artery "from 2nd part of axillary a.
2- Perforating branches in 2nd, 3rd & 4th intercostal spaces from int. thoracic artery "Int. mammary a."
3- Branches from 2nd , 3rd & 4th intercostal arteries.
* Lymphatic drainage:
 Lymphatic vessel plexuses:
1) Subareolar lymph plexus of Sabbi: draining the skin including the nipple and areola.
2) Deep lymph plexus on pectoral fascia: draining the subareolar plexuses and the deep parts of the breast.
- Then the lymph vessels pass to pectoral group of axillary L.Ns  Then to  central group at the base of axilla  then to  apical group "at apex of axilla  Finally passes to the supraclavicular lymph nodes " above the clavicle ''

Lymphatic drainage of the breast
 Other special direction of lymphatics:
1- The upper part may send lymphatics directly to the supraclavicular lymph nodes "without passing to axilla"
2- The med. part of the breast:
 May give lymph spread to int. mammary lymph nodes inside the chest.
 From the lower inner 1/4 the lymphatics is connected to lymphatics of rectus sheath  to umbilicus  then may reach the liver through falciform ligament.
 Hormonal control of growth of the breast tissues:
1) The growth of the duct under control of:
Oestrogens (ovary), growth hormone (pituitary), steroids (suprarenal gl.)
2) The proliferation of acini requires progesterone (ovary) & milk production requires prolactin (pituitary) & Milk ejection during suckling requires oxytocin.
SOURCE: Prof. AYMAN SALEM'S BOOK
Copyright: (Vascular Society of Egypt ) & (Medical Educational web)
Not to be reproduced without permission of Vascular Society of Egypt

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