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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.
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What area does the base of the breast cover? • Extends from lateral border of sternum to midaxillary line • From 2nd to 6th 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? • 15-20 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 Contralateral parasternal nodes Parasternal nodes Interpectoral (rotter’s) nodes Contralateral breast Subdiaphragmatic/hepatic nodes Inguinal lymph nodes (rare)
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