Gross Anatomy of Breast

PROF. DR. FAUZIAH OTHMAN

DEPT OF HUMAN ANATOMY

Extent of the breast Areola & nipple Blood supply & lymphatic drainage of breast

Breast Quadrants

Location : Prominent surface feature of ant thoracic wall

sternum to the mid axillary line (MAL) 2nd to 6th ribs

2/3 resting on the fascia of pectoralis major.1/3 resting on the fascia of the serratus ant.

Retromammary space (bursa) –between breast and pectorial fascia.

Skin ligaments (retinacula cutis) and suspensory ligament (of Coopers)

Lactiferous ducts : give rise to 15 – 20 lobules of glandular tissue : open independently to the nipple.

Areolar : is dotted with the papular of the openings of numerous sebaceous glands, which secrete oil substance that protect the nipple and areolar.

Deep to areolar – lactiferous sinus where small droplet of milk accumulates in the nursing mother.

Nipple :small projection of skin containing the outlets for 15-20 lactiferous ducts arranged cylindrically around the tip.

Arteries of mammary gland

Lateral mammary branches of lateral cutaneous branches of posterior intercostal arteries

Lateral mammary branches

Lateral thoracic a.

Thoracoacrominal trunk a.

Axillary a.

Branchial a.

Subclavian a.

Medial mammary branches

Internal thoracic artery & its perforating branches

VASCULATURE OF THE BREAST

Arterial supply

Medial mammary branches of perforating branches and anterior intercoastal branches of the internal thoracic artery, originating from the subclavian artery.

Lateral thoracic and thoracoacromial arteries, branches of the axillary artery.

Posterior intercostal arteries, branches of the thoracic aorta in the 2nd, 3rd and 4th intercostal spaces

Veins of mammary gland

Internal jugular v.

Subclavian v.

Cephalic v.

Axillary v.

Lateral thoracic v.

Lateral mammary vv.

Internal thoracic vein & its perforating branches

Medial mammary vv.

Venous drainage

Mainly to the axillary vein.

Some drainage to the internal thoracic vein.

Lymphatic drainage of the breast

Lymphatic drainage

Lymph passes from the nipple, areolar, and lobules of the gland to the subareolar plexus and from it:

≥ 75% esp from lat quad of breast drains from pectoralis (ant) nodes to the axillary lymph nodes.some drainage directly to other axillary nodes or even to interpectoral,deltopectoral, supraclavical or inferior deep cervical.

25 % remaining lymph particularly from the medial quadrants drains to the parasternal nodes or to the opposite breast.From lower quadrants passes deeply to the inferior phrenic (abdominal) nodes.

Lymph form skin of breast except nipple and areolar drain intoAxillary

Inferior deep cervicalInfraclavicular nodes

Parasternal nodes of both sides.

Axillary nodes drains intoInfraclavicular and supraclavicular into

Subclavian lymphatic trunk (drains lymph from upper limb).

Parasternal nodes entersBronchomedialstinal trunk (drains lymph from visceral thoracic)