PART 1 Breast Disease Anatomy Modified sweat gland between the superficial and deep layers of the chest wall Lying on 2nd-6th rib Cooper’s Ligament Fibrous band of tissue Anatomy Contains mainly fat tissue, connective tissue and glands 15-25 ducts Breast tissue extends into axilla (“tail”) Smallest, day 4-7 Tail Anatomy Ducts Terminal ductules Milking forming glands Lobule Ducts cancer in situ (DCIS) Lobules cancer in situ (LCIS) Anatomy Breast is divided into quadrants Upper-Outer quadrant has the greatest mass UOQ is the site of about half of all breast cancers Anatomy: lymphatics draining Axillary pathway
Internal mammary pathway
Communication pathway
Rectus sheath→liver Anatomy: Axillary lymph nodes Axillary lymph nodes defined by pectoralis minor muscle Level 1 – lateral Level 2 – posterior Level 3 – medial Long Thoracic Nerve Serratus anterior Thoracodorsal Nerve Latissimus Dorsi Intercostalbrachial Nerve Lateral cutaneous Sensory to medial arm & axilla Anatomy Hormonal Effects Estrogen Development of the breast and lactiferous ducts Progesterone Secretory acinar tissue – lobules Prolactin Synergizes the effect of estrogen and progesterone Breast Diseases Classifiation as etiology Congenital Malformation Trauma Inflammation Tumor (benign or malignant) Classifiation as anotomy Glandular breast parenchyma (gland and stroma ) Nipple-Areolar Complex Surrounding breast skin Management of Breast Diseases History Clinical Breast Exam Breast imaging Tissue sampling Therapy