Gross Appearance – Breast

by Craig Canby, PhD

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    00:01 Welcome to this lecture on “The Breast”. This slide lists the learning objectives that you should be able to answer at the conclusion of this presentation.

    00:12 Describe the external features of the breast. Describe the tissue elements of the breast.

    00:18 Describe the neurovasculature and lymphatic drainage of the breast.

    00:22 List the frequencies of cancer by location in the breast.

    00:27 Describe a sentinel node biopsy and its clinical purpose.

    00:31 Describe nerves that are vulnerable during a mastectomy.

    00:36 Describe how the milk line explains variations in the breast.

    00:41 And then we'll finish up by identifying the key take-home messages in the summary.

    00:47 And then we'll provide attribution for the images that are used throughout this presentation.

    00:55 Here is our body map and our focus will be on the area that we see in through here and then on the left as well. And our first slide, this slide depicts the gross appearance of the breast. It is an anterior view. The most conspicuous structure is this pigmented area, referred to as the areola, and in its center, you have an elevation and that elevated region is the nipple.

    01:34 If you take a look within the pigmented areola, you will see some bumps and these bumps that you see are sebaceous glands that are referred to as areolar glands. And their oily secretion will help lubricate the areola as well as the nipple and this is essential, particularly if the mother is nursing her infant. Here we're looking at the breast in a lateral view. The breast is said to overlie ribs 2, 3, 4, 5 and 6. It will generally run from the sternum to the midaxillary line. And in the lateral view, our midaxillary line would be approximately in this location. However, in this particular individual, the breast tissue does not quite make its way that far posteriorly because there is variability and that variability is due to variations in breast size.

    02:39 In addition, the nipple is said to overlie the 4th intercostal space. This is a more constant location in men. However, because of differences in breast size and the effects of aging, the nipple may be at a lower relationship. And if the breast does extend more toward the midaxillary line, that extension of breast tissue is referred to as the axillary tail or you can say the axillary tail of Spence. Spence is utilizing the eponym.

    03:20 The breast harbors various types of tissue elements and the breast will sit or reside on the fascia that covers the pectoralis major muscle. So, if we take a look here, we see the pectoralis major and then between the breast itself and the pectoralis major, throughout most of where it's located, that breast will sit on this pectoral fascia.

    03:47 The tissue elements within the breast, and again, these will be variable between women, you will have adipose tissue. And so, we see variable amounts of adipose tissue in this illustration. You'll also have variable amounts of connective tissue, which is shown here as these white components within the illustration. And these white components will attach to the surface of the skin, as you see here, for example, and as you see here.

    04:17 And these fibrous connective tissue components are referred to as the suspensory ligaments of the breast, also known as Cooper's ligaments. And then you'll have variable amounts of glandular tissue. And we see glandular elements, or profiles, throughout this illustration. And then these glandular profiles will have ductile components that will converge onto the nipple and you see some ducts. These are lactiferous ducts. You'll have 15 to 20 of these converging toward the nipple and as they make their way toward the nipple, you'll see that there's a dilatation here. That dilatation is the lactiferous sinus and then, for a short distance thereafter to the surface of the nipple, that that will narrow again.

    About the Lecture

    The lecture Gross Appearance – Breast by Craig Canby, PhD is from the course Abdominal Wall.

    Included Quiz Questions

    1. Ribs 2–6
    2. Ribs 1–4
    3. Ribs 3–7
    4. Ribs 4–8
    5. Ribs 4–9
    1. Cooper’s ligaments
    2. Axillary ligaments
    3. Spence ligaments
    4. Pectoralis ligaments
    5. Mammary ligaments
    1. 15–20
    2. 10–15
    3. 10–20
    4. 15–30
    5. 5–10

    Author of lecture Gross Appearance – Breast

     Craig Canby, PhD

    Craig Canby, PhD

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