DEVELOPMENTAL ANOMALIES:

Amastia (Absence of breast) bilateral absence of breast

tissue & nipple. When breast tissue is absent
unilaterally, the pectoral muscle is often absent.
Polymastia (Supernumerary breasts)more than one
breast in one or both sides.
Athelia (Absence of nipple)
Polythelia supranumerary nipples are situated irregularly
over the breast & not on milk ridge.
POSITION & EXTENT
2/3 rests on pectoralis
major,
1/3 on serratus anterior,
while its lower medial
edge just overlaps the
upper part of the
rectus sheath.

It is a modified sweat
gland
Location : In the superficial fascia of the pectoral region.
Boundary :
Vertically: 2nd to 6th ribs.
Horizontally: lateral border of sternum to mid-axillary line.
Extension :
Above: Clavicle
Below: 7th to 8th ribs
Medially: Midline
Posteriorly : to the edge of latissimus dorsi
NAMING THE QUADRANTS FOR THE PURPOSE OF
DESCRIBING A LUMP
Or
1. Upper medial
quadrant
2. Upper lateral
quadrant
3. Lower medial
quadrant
4. Lower lateral
quadrant
 STRUCTURE

Skin:
Nipple
Areola
Parenchyma
Stroma
These lobules are separated by
fibrous septa running from the
subcutaneous tissues to the fascia
of the chest wall (the ligaments of
Cooper/ Astley Cooper fibers/
suspensory ligaments)
SKIN TETHERING

Larger Dimples Result from cancerous invasion

of the glandular tissue and fibrosis which
causes shortening or place traction of the
suspensory ligaments .
RETRACTION OF NIPPLES

Infiltration of Lactiferous Ducts and their

consequent fibrosis results in nipple retraction
or subareolar breast cancer result in nipple
retraction
PEAU DORANGE
Interference with the lymphatic drainage by cancer
may cause lymphedema, which in turn may
result in deviation of the nipple and a thickened
,leather like appearance of the skin. Prominent
or puffy skin between dimpled pores give it an
orange peel like appearance.
CROSS SECTION
BLOOD SUPPLY
Arterial supply

Lateral thoracic & Superior thoracic

branches of axillary.A
Perforating branches of internal
thoracic artery
Lateral branches of 2nd,3rd & 4th
posterior inter costal artery
VENOUS DRAINAGE
VENOUS DRAINAGE
k/A circulus venosus
Superficial veins drains into Internal thoracic vein & Superficial
veins of neck
Deep veins drains into
Internal thoracic vein, Axillary & Posterior intercostal vein

Sub areolar venous plexus

Posterior intercostal veins communicate with internal vertebral
venous plexus veins - therefore cancers can spread to vertebra-
may cause back pain
 NERVE SUPPLY

Anterior & lateral cutaneous branches

of 4th 6th intercostal nerves
conveys both
Sensory fibres skin
Autonomic fibres- smooth muscle of
blood vessels

Milk secretion by Prolactin,not by

nerves.
LYMPHATIC DRAINAGE
LYMPHATIC VESSELS
Lymphatics resemble veins in structure.
Elastic in nature.
Have valves which prevents backflow.
Along their length ,lymph nodes are present.
In Breast ,two types-
1)Superficial Lymphatic's-Drains skin over the Breast except
nipple and areola
2)Deep Lymphatic's- a) Drains the Parenchyma of Breast .
b) Also drains the nipple and areola.
Axillary (85%) (Sentinel Internal mammary /
Lymph Node) Parasternal (10%)
Anterior Others (5%)
Central Supraclavicular
Apical Cephalic / Deltopectoral
Lateral Posterior intercostal
Posterior Subdiaphragmatic
Inter pectoral Subperitoneal
A subareolar plexus of lymphatics below the nipple (the plexus of Sappey)
75% axillary
15% internal mammary
Upper can go to supraclavicular
Lower 2 quadrants can go to subdiapragmatic or abdominal nodes
DERMATOMAL SUPPLY
The apex of the axilla is defined by the costoclavicular
ligament (Halsteds ligament), at which point the
axillary vein passes into the thorax and becomes the
subclavian vein. Lymph nodes in the space between
the pectoralis major and minor muscles are termed
the interpectoral group or Rotters nodes,
THANK YOU