Mammography lesson 1

Present in

both sexes

Rudimentary in

male

well developed in_____after puberty

female

Situated within the

superficial pectoral fascia

The superficial fascia splits to enclose the breast to form the ____

anterior and posterior lamellae

Vertically:___ (from the clavicle above the 7th/8th rib below

2nd to 6th ribs

Horizontally

Midline/lateral border of sternum to mid-axillary line

The floor is formed by the

deep pectoral fascia

This overlies____ and _____ and___ and its ___

pectoralis major, serratus anterior superiorly, external oblique, aponeurosis inferiorly

Pectoralis major

1.Major muscle mass posterior to breast

2. Lymphatics from breast pierce and circumvent it

Pectoralis minor

1. Superior portion crosses anterior to axillary sheath, dividing the axilla into low, mid and high regions.

2. Interpectoral nodes lie immediately anterior

Serratus anterior

1. Medial wall of axilla

2. Major muscle mass deep to lateral one-third of breast

Latissimus dorsi

1. Post wall of axilla

2. Fascia continuous with axillary fascia

Named after ____ , a Scottish surgeon.

James Spence

The superolateral quadrant is prolonged towards the axilla along the lower edge of pectoralis major, from which it projects a little

Axillary tail

Structure of mammary: Skin

Nipple

Areola

Parenchyma

2,3,5,6

Stroma

1,4

The____ is composed mostly of collagenous dense connective tissue and contains numerous elastic fibres which wrinkle the overlying skin

nipple

The nipple is composed mostly of collagenous dense connective tissue and contains numerous elastic fibres which wrinkle the overlying skin. Usually lies above the inframammary crease, level with the (just lateral to the midclavicular line)

4th rib

The average nipple to sternal notch measurement in youthful, well-developed breast is

21-22 cm

Lobes

15- 20

in number Composed of glandular structures called lobules which empty via ductules into lactiferous ducts

Lactiferous ducts

Draining each lobe of the breast pass through the nipple and open onto its tip as 15-20 оorifices.

Contains ampulla near its end

Anchored to the pectoralis fascia by the suspensory ligaments that were first described by _____

Astley Cooper in 1840

Run throughout the breast tissue parenchyma from the deep fascia beneath the breast and attach to the dermis of the skin

Suspensory Ligament of Cooper

Axillary artery

Superior thoracic

Thoracoacromial artery

Lateral thoracic artery

Subscapular artery.

Internal thoracic:

Perforating branches to the anteromedial breast.

follow the arteries

Veins

drain into Internal thoracic vein & superficial veins of the lower part of the neck

Superficial veins

drain into Internal thoracic, Axillary & Posterior intercostal veins.

Deep veins

by their Anterior & Lateral cutaneous branches

4th to 6th intercostal nerves

The nipple is supplied from the anterior branch of ____

the lateral cutaneous branch of T4

ecretory activities of the gland are largely controlled by ____ rather than by efferent motor fibers.

ovarian and hypophyseal hormones

The breast is originally an ectodermal tissue, thus its _____is mostly parallel to the lymph flow of the overlying skin

lymphatic drainage

Axillary (85%)

Anterior

Posterior

Central

Lateral

Apical

Interpectoral

Internal mammary / Parasternal

10%

Others (5%)

Supraclavicular

Cephalic / Deltopectoral

Posterior

intercostal

Subdiaphragmatic

Subperitoneal

These are some____ in number,

20–40

Anterior (4-5)

Lying deep to pectoralis major along the lower border of pectoralis minor.

Posterior (6-7)

along the subscapular vessels

Lateral (4-6)

along the axillary vein

Central (3-4)

In the axillary fat

Apical (6-12)

Through which all the other axillary nodes drain, at the apex of the axilla above pectoralis minor and along the medial side of the axillary vein

____ They are variable in number and lie along the internal mammary vessels deep to the plane of the costal cartilages.

Internal mammary or parasternal nodes

___ A few nodes lying between the pectoralis major and minor muscles.

Inter pectoral nodes (rotter's nodes)

___ Some lymph from the breast also reaches the supraclavicular nodes, deltopectoral nodes, posterior intercostal nodes, subdiaphragmatic and sub peritoneal plexuses.

Supraclavicular and other nodes