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FEMALE BREAST
OBJECTIVES
• By the end of the lecture, the student should be
able to:
• Describe the shape and position of the female breast.
• Describe the structure of the mammary gland.
• List the blood supply of the female breast.
• Describe the lymphatic drainage of the female breast.
• Describe the applied anatomy in the female breast.
Parts, Shape & position of the Gland
• It is conical in shape.
• It lies in superficial
fascia of the front of
chest.
• It has a base, apex
and tail.
• Its base extends from
2nd
to 6th
ribs.
• It extends from the
sternum to the
midaxillary line
laterally.
• It has no capsule.
SHAPE AND POSITION OF FEMALE BREAST
• 2/3 of its base lies
on the pectoralis
major muscle, while
its inferolateral 1/3
lies on:
• Serratus anterior &
• External oblique
muscles.
• Its superolateral
part sends a process
into the axilla called
the axillary tail or
axillary process.
• Nipple:
• It is a conical eminence that
projects forwards from the
anterior surface of the breast.
• The nipple lies opposite 4th
intercostal space.
• It carries 15-20 narrow pores
of the lactiferous ducts.
• Areola :
• It is a dark pink brownish
circular area of skin that
surrounds the nipple.
• The subcutaneous tissues of
nipple & areola are devoid of
devoid of
fat.
fat.
SHAPE AND POSITION OF FEMALE BREAST
STRUCTURE OF MAMMARY GLAND
• It is non capsulated gland.
• It consists of lobes and lobules
which are embedded in the
subcutaneous fatty tissue of
superficial fascia.
• It has fibrous strands
(ligaments of cooper) which
connect the skin with deep
fascia of pectoralis major.
• It is separated from the deep
fascia covering the underlying
muscles by a layer of loose
areolar tissue which forms the
retromammary space. What is
its Importance? (allows the breast to move
freely).
STRUCTURE OF MAMMARY GLAND
• It is formed of 15-20 lobes.
• Each lobe is formed of a
number of lobules.
• The lobes and lobules are
separated by interlobar and
interlobular fibrous & fatty
tissue, called ligaments of
Cooper. (Importance)?These
ligaments give the breasts support by connecting the skin of
the breasts to the pectoralis muscles below them.
• It has from 15-20 lactiferous
ducts which open by the
same number of openings on
the summit of the nipple.
ARTERIAL SUPPLY
• 1. Perforating
branches of internal
thoracic (internal
mammary) artery.
• 2. Mammary
branches of lateral
thoracic artery.
• 3. Mammary
branches of
Intercostal arteries.
VENOUS SUPPLY
• Veins are
corresponding to
the arteries.
• Circular venous
plexus are found
at the base of
nipple.
• Finally, veins of
this plexus drain
into axillary &
internal thoracic
veins.
AXILLARY LYMPH NODES
• They are arranged into 5 groups
5 groups which
lie in axillary fat :
• Pectoral (Anterior) group : which lies
on the pectoralis minor along lateral
thoracic vessels.
• Subscapular (Posterior) group : which
lies on posterior wall of axilla on lower
border of subscapularis along
subscapular vessels.
• Brachial (Lateral) group : lies on lateral
wall of axilla along 3rd
part of axillary
vessels.
• Central group : lies in axillary fat at the
base of axilla.
• Apical group : lies at apex of axilla.
• Subclavian lymph trunk:
• it is formed by union of efferent lymph
vessels of apical group. It usually opens
in subclavian vein. On the left side it
usually opens into thoracic duct.
LYMPHATIC DRAINAGE
• Subareolar lymphatic
plexus :
• Lies beneath the areola.
• Deep lymphatic plexus:
• Lies on the deep fascia
covering pectoralis
major.
• Both plexuses radiate in
many directions and
drain into different
lymph nodes.
LYMPHATIC DRAINAGE • Central & lateral parts of the
gland (75%) drain into pectoral
group of axillary lymph nodes.
• Upper part of the gland drains
into apical group of axillary lymph
nodes.
• Medial part drains into internal
thoracic (parasternal) lymph
nodes, forming a chain along the
internal thoracic vessels.
• Some lymphatics from the medial
part of the gland pass across the
front of sternum to anastomose
with that of opposite side.
• Lymphatics from the inferomedial
part anastomose with lymphatics
of rectus sheath & linea alba, and
some vessels pass deeply to
anastomose with the sub
diaphragmatic lymphatics.
APPLIED ANATOMY- CANCER BREAST
• It is a common surgical condition.
• 60% of carcinomas of breast
occur in the upper lateral
quadrant.
• 75% of lymph from the breast
drains into the axillary lymph
nodes.
• In case of carcinoma of one
breast, the other breast and the
opposite axillary lymph nodes are
affected because of the
anastomosing lymphatics
between both breasts.
• In patients with localized cancer
breast, a simple mastectomy,
followed by radiotherapy to the
axillary lymph nodes is the
Applied Anatomy
• The lactiferous
ducts are radially
arranged from the
nipple, so incision
of the gland should
be made in a radial
direction to avoid
cutting through the
ducts.
• Infiltration of the
ligaments of
Cooper by breast
cancer leads to its
shortening giving
peau de’orange
appearance of the
breast.
Mammary ridge
Mammary ridge
• Mammary ridge
Mammary ridge
extends from the
extends from the axilla
axilla
to the
to the inguinal region.
inguinal region.
• In human,
In human, the ridge
the ridge
disappears
disappears EXCEPT
EXCEPT for a
for a
small part in the
small part in the
pectoral region
pectoral region.
.
• In animals,
In animals, several
several
mammary glands
mammary glands are
are
formed along this ridge.
formed along this ridge.
THANK YOU

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Lecture5 femalebreast-180321033233

  • 2. OBJECTIVES • By the end of the lecture, the student should be able to: • Describe the shape and position of the female breast. • Describe the structure of the mammary gland. • List the blood supply of the female breast. • Describe the lymphatic drainage of the female breast. • Describe the applied anatomy in the female breast.
  • 3. Parts, Shape & position of the Gland • It is conical in shape. • It lies in superficial fascia of the front of chest. • It has a base, apex and tail. • Its base extends from 2nd to 6th ribs. • It extends from the sternum to the midaxillary line laterally. • It has no capsule.
  • 4. SHAPE AND POSITION OF FEMALE BREAST • 2/3 of its base lies on the pectoralis major muscle, while its inferolateral 1/3 lies on: • Serratus anterior & • External oblique muscles. • Its superolateral part sends a process into the axilla called the axillary tail or axillary process.
  • 5. • Nipple: • It is a conical eminence that projects forwards from the anterior surface of the breast. • The nipple lies opposite 4th intercostal space. • It carries 15-20 narrow pores of the lactiferous ducts. • Areola : • It is a dark pink brownish circular area of skin that surrounds the nipple. • The subcutaneous tissues of nipple & areola are devoid of devoid of fat. fat. SHAPE AND POSITION OF FEMALE BREAST
  • 6. STRUCTURE OF MAMMARY GLAND • It is non capsulated gland. • It consists of lobes and lobules which are embedded in the subcutaneous fatty tissue of superficial fascia. • It has fibrous strands (ligaments of cooper) which connect the skin with deep fascia of pectoralis major. • It is separated from the deep fascia covering the underlying muscles by a layer of loose areolar tissue which forms the retromammary space. What is its Importance? (allows the breast to move freely).
  • 7. STRUCTURE OF MAMMARY GLAND • It is formed of 15-20 lobes. • Each lobe is formed of a number of lobules. • The lobes and lobules are separated by interlobar and interlobular fibrous & fatty tissue, called ligaments of Cooper. (Importance)?These ligaments give the breasts support by connecting the skin of the breasts to the pectoralis muscles below them. • It has from 15-20 lactiferous ducts which open by the same number of openings on the summit of the nipple.
  • 8. ARTERIAL SUPPLY • 1. Perforating branches of internal thoracic (internal mammary) artery. • 2. Mammary branches of lateral thoracic artery. • 3. Mammary branches of Intercostal arteries.
  • 9. VENOUS SUPPLY • Veins are corresponding to the arteries. • Circular venous plexus are found at the base of nipple. • Finally, veins of this plexus drain into axillary & internal thoracic veins.
  • 10. AXILLARY LYMPH NODES • They are arranged into 5 groups 5 groups which lie in axillary fat : • Pectoral (Anterior) group : which lies on the pectoralis minor along lateral thoracic vessels. • Subscapular (Posterior) group : which lies on posterior wall of axilla on lower border of subscapularis along subscapular vessels. • Brachial (Lateral) group : lies on lateral wall of axilla along 3rd part of axillary vessels. • Central group : lies in axillary fat at the base of axilla. • Apical group : lies at apex of axilla. • Subclavian lymph trunk: • it is formed by union of efferent lymph vessels of apical group. It usually opens in subclavian vein. On the left side it usually opens into thoracic duct.
  • 11. LYMPHATIC DRAINAGE • Subareolar lymphatic plexus : • Lies beneath the areola. • Deep lymphatic plexus: • Lies on the deep fascia covering pectoralis major. • Both plexuses radiate in many directions and drain into different lymph nodes.
  • 12. LYMPHATIC DRAINAGE • Central & lateral parts of the gland (75%) drain into pectoral group of axillary lymph nodes. • Upper part of the gland drains into apical group of axillary lymph nodes. • Medial part drains into internal thoracic (parasternal) lymph nodes, forming a chain along the internal thoracic vessels. • Some lymphatics from the medial part of the gland pass across the front of sternum to anastomose with that of opposite side. • Lymphatics from the inferomedial part anastomose with lymphatics of rectus sheath & linea alba, and some vessels pass deeply to anastomose with the sub diaphragmatic lymphatics.
  • 13. APPLIED ANATOMY- CANCER BREAST • It is a common surgical condition. • 60% of carcinomas of breast occur in the upper lateral quadrant. • 75% of lymph from the breast drains into the axillary lymph nodes. • In case of carcinoma of one breast, the other breast and the opposite axillary lymph nodes are affected because of the anastomosing lymphatics between both breasts. • In patients with localized cancer breast, a simple mastectomy, followed by radiotherapy to the axillary lymph nodes is the
  • 14. Applied Anatomy • The lactiferous ducts are radially arranged from the nipple, so incision of the gland should be made in a radial direction to avoid cutting through the ducts. • Infiltration of the ligaments of Cooper by breast cancer leads to its shortening giving peau de’orange appearance of the breast.
  • 15. Mammary ridge Mammary ridge • Mammary ridge Mammary ridge extends from the extends from the axilla axilla to the to the inguinal region. inguinal region. • In human, In human, the ridge the ridge disappears disappears EXCEPT EXCEPT for a for a small part in the small part in the pectoral region pectoral region. . • In animals, In animals, several several mammary glands mammary glands are are formed along this ridge. formed along this ridge.