This is a brief presentation regarding the normal female breaat anatomy which consisting of the gross and internal structure of mammaru gland with its applied aspects (breast carcinoma)

1. Anatomy of the
Mammary Gland
By : Muhamad Afif Bin Roslan
PBL group 6
MBBS UniSZA
Learning Outcomes:
i. Describe the location,extension and gross features of breast
ii. State the blood supply and nerve supply to the breast
iii. Describe the lymphatic drainage of breast
iv. State the clinical application of mammary gland 1

2. I. A:Location and extension of the breast
• Lies within superficial fascia (in
subcutaneous tissue) of anterior
thoracic wall
➢ Upper 2/3:
• Overlies pectoral fascia
➢ Lower 1/3:
• Overlies fascia covering serratus
anterior muscle
• The circular base extends:
➢Transversely:
• -From lateral border of sternum to
midaxillary line
➢Vertically:
• 2nd through 6th ribs
Pectoral
fascia
Mammary
gland
Mid axillary
line
Lateral border
of sternum 2

3. I .B: External features of the breast
Areola
•Circular pigmented area
of skin
•Presence of areolar
glands
•No fat tissue, no hair
follicle
• Areolar (Montgomery)
glands Sebaceous
glands forming
rounded projections
from surface of areola
Nipple
•Cylindrical prominence in the centre of areola
•No fat, hair or sweat gland
•Contain circular smooth muscle fibers
•Tips are fissured with openings of lactiferous ducts
•Position varies:
➢ Nulliparous women: 4th Intercostal space
➢ Multiparous women: varies
The axillary process
/tail (of Spence)
Extends:
➢Along inferolateral
edge of pectoralis
major towards
axillary fossa
➢Extension of breast
tissue into axilla
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4. I. C: Internal features of breast
a. Suspensory Ligaments (of Cooper)
•Fibrous connective tissue stroma
•Well developed in the superior part of the gland
Function:
➢Attaches mammary gland to dermis of
overlying skin
➢Help to support the lobules of the gland
b. Retromammary Space
•Potential space or loose connective tissue
plane between the breast and pectoral fascia
•Contains small amount of fat & lymphatic
tissue
✓ Allows the breast some degree of
movement on the pectoral fascia
Pectoral
fascia
Gland
lobules
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5. I. C: Internal features of breast
➢Glandular Tissue
•Tissue that secretes milks
•Arranged in lobes (15 to 20 lobes)
•Embedded in connective tissue and fat
•Each lobe is composed of several lobules
•Each lobule is composed of several alveoli
➢Lactiferous duct
•Excretory duct that drains each lobes
•Each lobe has 1 lactiferous duct
•Opens through a separate constricted
opening on the surface of the nipple
➢ Lactiferous sinus (Ampulla)
•Dilatation of lactiferous duct deep to areolar
before it opens on the surface of the nipple
❖Stores droplet of milk
❖Allow expression of milk by compression
lobules
Lactiferous
sinusLactiferous
duct
Lobe
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6. II.A: Blood supply to breast
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7. • Anterior & lateral cutaneous branches of 4th - 6th
Intercostal nerves
• These branches convey 2 fibers:
II.B: Nerve supply to breast
Fibers Area/part supplied
Sensory fibers ▪ Skin of the breast
Symphatetic fibers ▪ Blood vessels
▪ Smooth muscles
in the overlying
skin & nipple
Intercostal
nerves
T4
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8. III. Lymphatic drainage of breast
➢ Very important !!! Spread of breast cancer
•Can be divided into:
1)Superficial lymphatic drainage:
-Drains the skin of the breast EXCEPT areola &
nipple
2)Deep lymphatic drainage:
-Drains the glandular tissue of the breast
INCLUDING areolar & nipple
-Passes to the subareolar lymphatic plexus
into axillary lymph nodes
Superficial lymphatic drainage lymph nodes:
1)Axillary lymph nodes
2)Infraclavicular lymph nodes
3)Inferior deep cervical lymph nodes
4)Parasternal nodes
1
2 3
4
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9. Quadrants of breast:
➢ Medial part:
1.Upper inner quadrant
2.Lower inner quadrant
➢ Lateral part :
3.Upper outer quadrant
4.Lower outer quadrant
III. Lymphatic drainage of breast
Deep lymphatic drainage:
Quadrant Lymph nodes
Lateral part
(Upper & Lower
outer quadrants)
Axillary lymph nodes (>75%)
•Mainly to anterior/pectoral
nodes
•Other axillary lymph nodes:
- Interpectoral nodes
- Deltopectoral nodes
- Supraclavicular nodes
- Inferior deep cervical
nodes
Medial part
(Upper & Lower
inner quadrants)
• Parasternal nodes (Internal
mammary nodes)
• May drain to opposite
breast
Lower quadrants
(Medial & lateral)
Inferior phrenic lymph nodes
(abdominal lymph nodes)
Upper
outer
quadrant
Upper inner
quadrant
Lower outer
quadrant
Lower inner
quadrant
MedialLateral
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10. IV. Clinical importance of breast
1. Breast cancer:
–Usually arise from ductal epithelium
–Most common site is upper outer
quadrant
–Early symptom is presence of painless
hard lump in breast
–Spread of cancer cells : lymphatic /
local / blood
2. Peau D’Orange:
➢A symptom of inflammatory breast
cancer.
➢Cancer cells block the lymphatic
vessels- fluid accumulation in the
breast causing edema.
➢Skin appearance have ridges or
appear pitted, like the skin of an
orange.
Paeu D’Orange appearance
Breast
carcioma
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11. THANK YOU
References :
• Clinical Anatomy (Keith L. Moore)
• Gray’s Anatomy for students (Richard L. Drake)
• Dr Nurfarhana Che Lah, Anatomy of mammary gland,Lecture Notes
Fakulti Perubatan UniSZA 2019
• Robbin’s Basic pathology of diseases
Any QUESTIONS????
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