Anatomy and Development of Breast (Mammary Gland) Dr. Sama ul Haque Objectives Describe the gross structure of the breast. Give its blood supply and lymphatic drainage. Discuss the development of breast and its congenital anomalies. Breast (Mammary Gland) Modified Sweat Glands of the skin Functional in females (Milk secretion) Rudimentary and functionless in males Shape: Hemispherical Breast (Mammary Gland) Extent: Vertical: 2nd to 6th rib (Base of the breast) Horizontal: Lateral margin of the sternum to the midaxillary line 2/3rd of the breast lies in the superficial fascia (Pectoral fascia) lying on Pectoralis major 1/3rd of the breast lies in the superficial fascia lying on Serratus Anterior Breast (Mammary Gland) Nipple: Conical or Cylindrical prominence in the center of Areola (Devoid of fat, hair & sweat gland) Surface anatomy: 4th intercostal space lateral to midclavicular line!!!! Areola: Circular pigmented area of the skin surrounding the base of the nipple, containing sebaceous glands Axillary Tail : Small part of the breast extending (of Spence) to the axilla Breast Breast Breast (Mammary Gland) Retromammary Space: Space filled with loose connective tissue between breast and pectoral fascia Each breast consists of 15 to 20 lobules Lactiferous ducts from each lobule open on the summit of the nipple separately Lactiferous duct possesses a dilated Ampulla (Lactiferous sinus) just before its termination Breast (Mammary Gland) Fibrous septa separates the lobes of the mammary gland Suspensory ligaments (of Cooper): Mammary gland is firmly attached to the dermis of the skin by these fibrous septa forming suspensory ligaments Breast Arterial Supply of the Breast Perforating branches (Internal thoracic artery) Lateral thoracic artery (Axillary artery) Thoracoacromial artery (Axillary artery) Intercostal arteries Arterial Supply of the Breast Venous Drainage of the Breast Nerve supply • Anterior and lateral cutaneous branches of the 4th – 6th intercostal nerves Quadrants of the Breast Lymphatic Drainage of the Breast Lateral quadrants: Anterior Axillary or Pectoral Nodes Medial quadrants: Internal thoracic group of Nodes (Parasternal) Few lymph vessels drains into Posterior intercostal Nodes Lymphatic Drainage of the Breast Inferior quadrants: May drain into abdominal lymph Nodes Some lymphatic vessels communicate with the lymphatic vessels of the opposite breast Lymph Drainage of Breast Comparison of active & inactive phase Changes in mammary gland Development of the Breast Modified Sweat glands First appear as bilateral bands of thickened epidermis called the mammary lines (mammary ridges) In the 7th week these lines extend on each side of the body from Forelimb to the region of Hindlimb Development of the Breast Major part of each mammary lines disappears shortly Small portion of the mammary lines in the thoracic region persists & penetrates the underlying mesenchyme Here it forms 16 to 24 sprouts which in turn give rise to small solid buds Development of the Breast By the end of prenatal life, the epithelial sprouts canalize and form lactiferous ducts Initially lactiferous ducts open into a small epithelial pit which shortly after birth transformed into nipple At birth lactiferous ducts are devoid of alveoli At puberty alveoli and excretory ducts form due to hormonal changes Development Anomalies of the Breast Polythelia (Accessary Nipples) Accessary nipples have formed due to the persistence of fragments of the mammary line May develop anywhere along the mammary line but usually appear in the axillary region Development Anomalies of the Breast Polymastia (Supernumerary breasts) Occurs when a remnant of the mammary line develops into a complete breast Inverted Nipple Lactiferous ducts open in the original epithelial pit that has failed to evert. Development Anomalies of the Breast Development Anomaly of the Breast Gynecomastia Enlargement of breasts in males Causes May be at puberty (Usually regresses) Drugs side effects Prostatic cancer therapy Hormonal imbalance Thank you