BREASTSEMINAR SURGERY UNIT 3CMC HOSPITAL LARKANA

By : sanaullah shaikh

Discussed N understand

»breast embryology»Breast anatomy»Breast physiology

» Embryologically part of integumentary system

» Functionally part of reproductive system

» Modified apocrine sweat gland

» Present in males and females

» In males it is rudimentary

» In females at puberty gland enlarges

» Breast development starts during foetal life

» Around 6th week of gestational age milk line appears

» at 9th week involutes sparing the chest area

» Around the 12th week, ingrowth of ectoderm forms primary bud tissue in mesenchyme

» primary bud tissue starts development of 15 -20 secondary buds

» these secondary buds give rises to lactiferous ducts

» Mesenchyme gives rises to stromal tissue

» From birth until puberty, the breast consists of lactiferous ducts, with no alveoli.

» At puberty, the ducts start to proliferate

ANATOMY

POSITION AND ATTACHMENT

•LATERAL ASPECT OF PECTORAL REGION•LOCATED BETWEEN RIBS 3 AND 7•EXTENDS FROM STERNUM TO AXILLA•SURROUNDED BY SUPERFICIAL FASCIA•REST ON DEEP FASCIA

» 4rth intercostal space» Hairless skin» Composed of collagenous tissue» Containing melanocytes» Smooth muscle cells» 15-20 lactiferous ducts open on to its tip

» The areola is a disc of skin, which circles the base of the nipple,

» Melanocytes are quite numerous » varying in colour from pink to dark brown

depending on parity and race.» Contain modified sebacious glands» These glands enlarged during pregnancy called

tubercles of montogmery

Composed of» glandular tissue» stromal fibrous tissue» adipose tissue

• Glandular tissue» composed of 15-20 pyramidal lobes» each lobe contain 20-40 lobules but a separate lactiferous

duct» Each lobule holds tiny, hollow BLIND ENDED sacs (alveoli)

with their associated alveolar ducts that carry milk from the alveoli towards terminal lactiferous duct

• ADIPOSE TISSUE » Highly variable

• STROMAL TISSUE» Encloses lobules

Arterial supply• Branches of Axillary artery• Branches of internal thoracic artery

» Venous Drainage of BreastTributaries axillary veinTributaries of Internal thoracic vein

» The main function of breast is secretion and excretion of milk

» Generally, regulation of breast development and functions is done by four hormones

» Both Estrogen and progestrone are responsible for development of breast ductal system and deposition of fats on the breast.

• Sudden drop of progesterone and estrogen levels initiate lactation

• During lactation, milk production is stimulated by prolactin hormone from anterior pituitary gland

• Excretion of milk from breast than done by oxytocin hormone from posterior pituitary gland

- Both prolactin and oxytocin are released by the act of suckling which stimulates sensory nerve endings of nipple.

If you judge people, you have no time to love them. “mother teresa”