for undergraduates and post graduates

1. BREAST
ANATOMY & PHYSIOLOGY
Dr.Kushalini
PEGAWAI PERUBATAN
JABATAN PEMBEDAHAN
HOSPITAL SEBERANG JAYA

3. Mammary ridge
4

4. • Mammary line
Axilla to inguinal region
• Accessory breast tissue
(polythelia)
o Thoracic region 90
o Axilla 05
o Abdomen 05

5. •Secondary
sexual feature
•Nutrition for the
neonate

6. 1. Chest wall.
2. Pectoral muscles.
3. Lobules (glands that
make milk).
4. Nipple surface.
5. Areola.
6. Lactiferous duct
tube that carries milk
to the nipple
7. Fatty tissue.
8. Skin.
THE NORMAL BREAST

8. - In the superficial fascia of the pectoral region.
 Vertically: 2nd to 6th ribs.
 Horizontally: lateral border of sternum to mid-
axillary line.
• Above: Clavicle
• Below: 7th to 8th ribs
• Medially: Midline
• Posteriorly : to the edge of latissimus dorsi

9. Skin
2nd rib
6th rib
Pectoralis major
Fat

12. Deep relations:

13. • Skin:
– Nipple
– Areola
• Parenchyma
• Stroma

14. Tubercle of Montgomery
Nipple
Areola
Skin

15. Nipple
• Covered by thick hairless skin
• 4th intercostal space
• Colour varies
• Adipose tissue
• Fibrous connective tissue
• Epithelial secretory tissue
• Lactiferous ducts opening(15 – 20)
• usually everted & erectile .

16. Areola
 Around the nipple
 Colour varies
 smooth muscles (circular & radial layout)
 sweat & sebaceous glands
• Tubercles of Montgomery
• sebaceous glands enlarge during pregnancy & lactation

17. Parenchyma:
 Lobes:
- 15 – 20 in number
- Composed of minute glandular
structures called lobules
- Lobules empty via ductules in
lactiferous ducts
 Lactiferous ducts:
- Open on to nipple
- Contains ampulla near its end
(Reservoir of milk or abnormal discharge)
Lobules
Ductules
Lactiferous duct
Lactiferous sinus
Nipple

19. Stroma:
Partly fibrous & partly fatty
• Ligaments of Cooper:
- Anchors the breast with skin
- Cancer cells may infiltrate
these ligaments, so the breast
becomes fixed & contraction of
the ligaments can cause retraction
or puckering (folding) of the skin.

20. Non-lactating Lactating

21. Blood Supply:
Arterial supply
1. Internal thoracic artery – perforating branches
2. Axillary artery –
1. Lateral thoracic artery
2. Superior thoracic artery
3. Acromiothoracic artery
3. Posterior intercostal arteries – lateral branches
Arteries are distributed in the anterior surface.
Posterior surface is relatively avascular.

22. Internal thoracic
artery
Axillary artery
Lateral thoracic
artery
Superior thoracic
artery
Acromiothoracic
artery
Posterior intercostal
arteries

23. o Veins follow the arteries.
o First converge around the nipple to form an
anastomotic venous circle & then form 02 sets of
veins.
• Superficial veins: drain into Internal thoracic
vein & superficial veins of the lower part of
the neck
• Deep veins: drain into Internal thoracic ,
Axillary & Posterior intercostal veins

24. Internal thoracic vein
Axillary vein
Anastomotic
venous circle

26. THE LYMPHATIC SYSTEM
Lymphatic System which consists of vessels
and
organs plays two vital roles in our lives:
1) The vessels essentially maintain interstitial
fluid levels by carrying excess fluids as well
as any plasma proteins, back into the CVS.
2) The organs, house critical immune cells
such as lymphocytes which carry out our
body defense against infection.

27. THE LYMPHATIC SYSTEM
Most of the lymph vessels of the breast
drain into:
• Lymph nodes under the arm (auxiliary
nodes).
• Lymph nodes around the collar bone
(supraclavicular and infraclavicular lymph
nodes)
• Lymph nodes inside the chest near the
breast bone (internal mammary lymph

29. Axillary lymph nodes
Anterior
Central
Apical
Lateral
Posterior
Interpectoral
Internal
mammary
lymph
nodes

30. Devoid of valves.
• Superficial lymphatics  skin over breast except
nipple & areola
• Deep lymphatics  parenchyma as well as nipple &
areola
• Subareolar plexus
(of Sappy)
Subareolar plexus
of Sappy

32. • 4th to 6th intercostal nerves
by their Anterior & Lateral
cutaneous branches;
• Milk secretion by Prolactin,
not by nerves

34. Post Natal Development
PUBERTY PHASE
I. Elevation of the nipple
II. Glandular subareolar tissue of
nipple and breast projecting
from chest wall as single mass.
III. Pigmentation of areola,breast
tissue increases
IV. Areola & nipple form a
secondary mass
V. Smooth contour of the breast

36.  Amastia (Absence of breast)
 Polymastia (Supernumerary breasts)
 Athelia (Absence of nipple)
 Polythelia (Supernumerary nipples)
 Gynaecomastia (in Klinefelter’s syndrome)

37. Amastia of right breast
Polymastia
Polythelia
Nipple retraction
Athelia
Gynaecomastia

38. PHYSIOLOGY

39. - Important accessory organ of the female
reproductive system.
- Provides nutrition to the new born in the form of
milk.

40. Physiology

42. Feed Your Faith, Your Fears Will Starve To Death

43. question
1. One of the breast function is for lactation(true/false).
ans: true
2. The structure of breast involve parenchyma alone.(true/
false) ans: false
1. Lactiferous ducts function as reservoir of milk or
abnormal discharge.(true/false) ans: true
2. During pregnancy there is increase in mammary blood
flow.(true/false) ans : true
3. During the 3rd stage of puberty phase there is increase
in pigmentation of aerola.(true/false) ans false