Breast anatomy
What area does the base of the breast cover? Extends from lateral border of sternum to midaxillary line From 2 nd to 6 th ribs Small part may extend towards the axilla – the axillary tail
What two muscles does the breast overly? Pectoralis major Serratus anterior
What separates the breast from the underlying muscle? Retromammary space A potential space filled with loose connective tissue
How is the breast attached to the skin that overlies it? Suspensory ligaments of Cooper Helps support the lobules of the breast
On what line does the nipple lie? Mammary ridge/milk line From the anterior axillary fold to the groin Supernumerary nipples can be occur along this line Also axillary breasts
How is the breast divided for descriptive purposes? Quadrants
What glands are found on the areola? Sebaceous (Montgomery) glands Secrete oily substance following pregnancy Oily substance protects the nipple from irritation
How many lobules are in the breast? How are they separated? lobules of glandular tissue Separated by suspensory ligaments of Cooper
Describe the drainage of milk from a lobule? Each lobule drains into a lactiferous duct Each lactiferous duct opens on the nipple
What arteries supply the breast? Medial mammary – From internal thoracic (mammary)/anterior intercostal Lateral mammary – From lateral thoracic artery & posterior intercostals
What is the nerve supply to the breast? T4-6 intercostal nerves
What different areas do the lymphatics of the breast drain to? Auxiliary nodes Parasternal nodes Contralateral parasternal nodes Contralateral breast Subdiaphragmatic/hepatic nodes Inguinal lymph nodes (rare) Interpectoral (rotter’s) nodes
What changes does the breast go through during pregnancy? (6) Lengthening and branching of ducts Development of secretory alveoli Vascularity increases Nipples enlarge Areola becomes more prominent Lobular structure more prominent
What effect do progesterone and oestrogen have on breast tissue? Progesterone – lobular development (growth) Oestrogen – ductal growth Combined – suppress lactation
Benefits of breast feeding Bonding Infection Cheap Convenient Sterile
Who should not breast feed Alcohol misuse Certain drugs-methotrexate, cyclosporine, lithium Active TB HIV Breast Cancer Rx Infant with galactosemia
Difficulties with Breast feeding 2/3 of women have some problem Cracked nipple Mastitis S. Aureus Preemie Need advice and support