DOCSLIB.ORG

Embryology and Anatomy of Breast

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Embryology and Anatomy of Breast Embryology and Anatomy of breast ‐B.Shivraj Gen Surg 1st unit The mammary gland • Modified apocrine sweat gland. • Present in both males and females. • Female ‐> serves for lactation; secondary sexual character. • About 4% women have amazia. Embryology • Develops from the integument. • Arises from the ventral surface of the embryo.(milk line‐> thickened line of ectoderm). • Ducts and acini from ectoderm • Supporting tissue from mesenchyme. Milk line *Milk line / mammary ridge‐> Develops from base of fore limb i.e. Axilla to hind limb i.e groin. *Except @ the level of nipple, rest of It gets atrophied. *Polythelia‐> m/c site 7‐10cm Below and medial to the nipple. • Dev @ 6th week of IU life. ‐>mammary ridge • @nipple‐>ectoderm grows inward 15‐20 solid rods (rudimentary gland)‐>bulbous dilation at ends‐>alveoli • @5th month IU life‐>cords develop • @7/8th month‐>hollowing of ducts; diff as milk ducts; depression at site of nipple. • @9th month‐> alveoli become canalised • @birth‐>mesenchyme proliferation‐> nipple everts; areola becomes pigmented. • @puberty‐> 15‐20 lact ducts have 15‐20 lobules each. • Witch’s milk‐> creamy white fluid cos of circulating maternal estrogens • Colostrum‐> intial milk secreted. Rich in antibodies cos of lymphocytes and plasma cells in the duct lining. • Later stage replaced by milk high in lipid content. Location • Situated in the anterior chest wall : 2‐6rib; sternum to mid‐axillary line; surrounded by the superficial fascia; resting on the deep fascia. overlying the pectoral fascia Breast: Fatty Tissue Nipple and areola complex • Nipple‐> 4th ICS. – Smooth muscles; circular and longitudinal – Erection‐>serves milk • Areola‐>sebaceous/areolar glands – Pigmented – Has hypertrophied sweat glands‐> glands of Montomery‐>serves for protective lubrication during lactation. Lobes and Lobules Anatomy • Ducts, acini‐>lobules‐>lobes‐> latiferous ducts‐>lactiferous sinus‐>nipple. • Suspensory ligaments of Astley Cooper‐skin and petoralis muscle. • Tail of spence‐ foramen of langer (d/d‐ lymph node); @ 3rd rib level ; Ln Blood supply • Arterial – – 1st part of subclavian‐>internal mammary art(medial mammary brs) along with 2,3,4th IC perf brs. abt 50% BS. – 2nd part of axillary‐> external mammary art(lateral thoracic brs)‐> lateral aspect – Pectoral branches of acromiothoracic artery‐> post. aspect • Superior thoracic br • Lateral perf br of IC art. • Br. of subscapular art. Arterial Supply to the Breast Subclavian a. Axillary a. Internal mammary External (thoracic) a. mammary (thoracic) a. Veins draining the Breast Subclavian vein External mammary vein Venous drainage • Follows the arteries. • Internal mammary v.‐> s/c v. • Lat thoracic ‐> ax. V • Lat. Perf. Br. Into IC v‐> vertebral v ‐> vertebral plexus‐> bone mets. “BATSON’S PLEXUS” Nerve supply • anterior & lateral br of 4‐6th IC n. • Nipple‐> T4 ; extensive plexus • Areola‐> fewer nerve endings. Lymph Nodes of the Breast Subclavian nodes Axillary nodes Parasternal Lateral nodes pectoral nodes Lymph drainage Lymphatic drainage • Is of great surgical importance • Arises in interlobular conn tissue and in walls of lactiferous ducts • Majoirty of breast drains into axillary LN. • 5groups: – Pectoral(anterior) – 75% – Subscapular(posterior) – Humeral(lateral) – Sublavicular(apical)‐ultimately – Central • Parasternal nodes • Rotter’s nodes • In relation to pec minor: – Level I – Level II – Level III ‐ Also to supraclavicular nodes. Routes of Metastasis • Across the sternum in lymphatics to opposite side via cross‐mammary pathways – Then to contralateral breast • From subdiaphragmatic lymphatics to nodes in abdomen – Then to liver, ovaries, peritoneum Major Routes of Metastasis Channels to Contralateral Breast Axillary Lymph Channels Subdiaphragmatic Lymph Channels Anomalies • Amazia – B/L ; U/L • Polymazia‐ loc. • Micro/macro • Polythelia / hyperthelia‐ loc. • Gynecomastia • Poland’s synd. • Turner’s synd. • Fleischer’s synd. • Varginal hypertrophy • Symmastia Applied surgical anatomy Clavipectoral fascia • Or costocoracoid / coracoclavicular fascia. • Under pec major muscle. • Upwards‐> encloses subclavius and attaches to clavicle. Post layer fuses with the deep cervical fascia and axillary vessel sheath. • Laterally‐> thickened and attached to coracoid process. • Bet 1st rib and coracoid process‐>costocoracoid lig. • Downwards‐>encloses pec. minor & continuous with axillary fascia. • Pierced by‐> cephalic v ; thoraco acromial art & v ; lateral pectoral nerve. Axilla • Pyramid; apex towards head ; base broader & towards arm. • Apex‐> outer surface of 1st rib; post aspect of clavicle; upper surface of scapula • Medially‐> 1,2,3,4th ribs with intercoastal muscles with serratus ant. • Laterally‐> humerus, biceps brachii, corachobrachialis. • Base ‐> axillary fascia(bet pec major & lat dorsi); med‐ broad, lat‐narrow • Ant‐>pec major, pec minor • Post‐>subscapularis, teres major, lat dorsi • Contents‐>Ax vessels, brachial plexus, Lymphatic system, intercoastal nerves, fat & loose areolar tissue. Cervico‐axillary canal Axillary fascia Dissection • Abduct arm at 90 degree. • Reflect lower skin flap until post. ax. fold is visible • LN and superficila v dissected. • 2 muscles: lat. S head of biceps; med‐ coracobrachialis • Medial borders defined • Axillary vessels skeletonised. • Long thoracic n and intercostobrachial n. THANK YOU.
Load more

Recommended publications
  • Polythelia -Six Nipples in Amiddle Varun Arunagiri in the Accessory Nipples
    Stanley Medical Journal CASE REPORT - GENERAL SURGERY Polythelia - Six Nipples in a middle aged woman Varun Arunagiri(1), Kothai Anbalagan(1) Abstract Vol 3 | Issue 2 | April - June | 2016 - June 2 | April 3 | Issue Vol Supernumerary nipples are more than two nipples which normally exist in humans. Polythelia or supernumerary nipple is a rare condition with higher prevalence in males than in females with the ratio of 1.7:1. The maximum reported number of nipples in a person with Polythelia is seven in a male. The usual presentation of Polythelia is with three nipples. Here is an image of Polythelia in a 40 year old female presenting with six nipples without lactation from the supernumer- ary nipples and any other anomalies. She has breast fed her two children. Key-words: Polythelia; Supernumerary Nipples; Mammary ridge; Kajava Classification; Clear cells of Toker. Key Messages: 1. Polythelia is a benign condition with chances of malignancy in the accessory nipples. 2. Constant follow-up is needed when the patient says lump in the region of accessory nipple. 3. Lactation during the pregnancy is common. INTRODUCTION: reported number of nipples in a person with Polythelia is seven in a male. The usual presentation of polythelia is with Polythelia is a congenital anomaly of the breast three nipples where in there are accessory nipples along the milk line Mammals have six to seven nipples, which are apart from the normal two nipples. Amazia, polymazia, common among canines and felines. It is rare to see humans Polythelia, athelia are few congenital anomalies of the nip- with more than three nipples.
    [Show full text]
  • Breast Carcinoma in Axillary Tail of Spence: a Rare Case Report
    International Journal of Current Research and Review Case Report DOI: http://dx.doi.org/10.31782/IJCRR.2020.9295 Breast Carcinoma in Axillary Tail of Spence: A Rare Case Report IJCRR 1 2 3 4 Section: Healthcare Rajesh Domkunti , Yashwant R. Lamture , Avinash Rinait , Dilip Gode Sci. Journal Impact Factor: 6.1 (2018) 1 2 ICV: 90.90 (2018) Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha-442001; Professor and HOD Dept. of Surgery, Datta Meghe Medical College Nagpur, Shalinitai Meghe Hospital and Research Centre, Nagpur-441110; 3Assistant Professor Dept. of Surgery, Datta Meghe Medical College Nagpur, Shalinitai Meghe Hospital and Research Centre, Nagpur-441110; 4Dean & Professor Dept. of Surgery, Datta Meghe Medical College Nagpur, Shalinitai Meghe Hospital and Research Centre, Nagpur-441110 ABSTRACT . Breast carcinoma is known to be one of the commonest malignant tumours among which Axillary breast cancer is a special individual that accounts for 0.1% to 2% of all cases of breast cancer. This is usually composed of poorly differentiated IDC with squamous or mesenchymal carcinoma areas sometimes. Axillary malignancy is difficult as there are many differential diagnoses that may require careful evaluation. This is a case report on Breast carcinoma of tail of Spence in axilla with skin involvement near nipple-areola complex whose histopathology was suggestive of infiltrating ductal carcinoma of axillary tail of Spence with mild dysplastic changes over right nipple-areola complex and high lymph node positivity (96.7%). Standard investigations like Ultrasonography of B/L Breast with Axilla and Tru-cut biopsy were done to reach the diagnosis of Intraductal Carcinoma (IDC) of the axillary tail.
    [Show full text]
  • A Study of Evaluation and Management of Rare Congenital Breast Diseases Surgery Section
    Original Article DOI: 10.7860/JCDR/2016/21077.8648 A Study of Evaluation and Management of Rare Congenital Breast Diseases Surgery Section RIKKI SINGAL1, SUDHIR KUMAR MEHTA2, JYOTI BALA3, MUZZAFAR ZAMAN4, AMIT MITTAL5, GUARAV GUPTA6, SAMER RUDRA7, SAMITA SINGAL8 ABSTRACT Results: Out of 32 cases: 1(3.125%) male patient had Introduction: Polymastia and polythelia may be asymptomatic unilateral and 1(3.125%) male had bilateral accessory nipple, or cause pain, restriction of arm movement, milk discharge, 7 (21.87%) females had unilateral and 1(3.125%) had bilateral cosmetic problems or anxiety. Cosmesis is the main indication accessory nipple, 1 (3.125%) diagnosed as accessory axillary for surgical excision of accessory breasts in axilla. In addition fibroadenoma in female, 16(50%) presented as unilateral and 5 it also confirms the diagnosis and allays the patient’s fear of (15.62%) had bilateral swelling in the axilla as accessory breast. harbouring a malignancy. Patients underwent surgical excision and in 8(25%) cases z- shaped incision was made in view of better cosmesis. Patients Aim: To evaluate the presentation of symptoms, investigations were followed up upto 6 months postoperatively. There were no required for diagnosis and the management to improve the residual swelling and movements of the arm over the shoulder treatment protocols in patients with breast diseases. joint were normal. In 3(9.37%) cases, wound dehiscence Materials and Methods: This retrospective study on breast occurred; in 2 (6.25%) cases lymphoedema formation was diseases presenting as supernumerary breasts and nipples seen. These were successfully managed conservatively. was conducted in the Department of Surgery between January Conclusion: As breast swellings either fibroadenoma or 2013 and January 2016 at MMIMS Research and hospital, carcinoma are common entities to come across everywhere Mullana, Ambala.
    [Show full text]
  • Diagnosis and Treatment of Accessory Breast Cancer in 11 Patients
    ONCOLOGY LETTERS 10: 1783-1788, 2015 Diagnosis and treatment of accessory breast cancer in 11 patients SHUO ZHANG1,2*, YONG-HUA YU2, WEI QU2, YONG ZHANG2* and JIA LI2 1School of Medical and Life Sciences, Shandong Academy of Medical Sciences, Jinan University, Jinan, Shandong 250200; 2Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong 250117, P.R. China Received August 21, 2014; Accepted May 8, 2015 DOI: 10.3892/ol.2015.3388 Abstract. The present study aimed to investigate the clinical from the ectodermal ridges, also known as the milk lines, on characteristics, diagnosis and treatment of accessory breast the ventral surface of the body, which extend from the axillae cancer, and contribute valuable information regarding this to the inguinal regions and end on the medial aspect of the rare tumour to the current literature, ultimately facilitating thighs on each side of the body (4). Embryologically, ectopic the development of improved treatment strategies. The present breast tissue develops as a result of failed resolution of the study reported the cases of 11 patients with accessory breast mammary ridge, an ectodermal thickening that extends from cancer. The patients with accessory breast cancer were the axilla to the groin (5). Ectopic breast tissue may appear at admitted between January 2002 and June 2014, and the patient any site along the milk line, but it occurs most commonly in records were retrospectively analysed. All patients presented the axill; less commonly, it may appear in locations outside with a tumour that was localised in the axilla. Out of these of the mammary ridge, including the face, middle back, patients, there were 8 patients with invasive ductal carcinoma buttock, posterior neck, chest, vulva, hip, posterior, flank and 3 patients with invasive lobular carcinoma.
    [Show full text]
  • Anatomy of the Breast Doctors Notes Notes/Extra Explanation Please View Our Editing File Before Studying This Lecture to Check for Any Changes
    Color Code Important Anatomy of the Breast Doctors Notes Notes/Extra explanation Please view our Editing File before studying this lecture to check for any changes. 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. Highly recommended Introduction 06:26 Overview of the breast: • The breast (consists of mammary glands + associated skin & Extra connective tissue) is a gland made up of lobes arranged radially .around the nipple (شعاعيا) • Each lobe is further divided into lobules. Between the lobes and lobules we have fat & ligaments called ligaments of cooper • These ligaments attach the skin to the muscle (beneath the breast) to give support to the breast. in shape (مخروطي) *o Shape: it is conical o Position: It lies in superficial fascia of the front of chest. * o Parts: It has a: 1. Base lies on muscles, (حلمة الثدي) Apex nipple .2 3. Tail extend into axilla Extra Position of Female Breast (حلقة ملونة) Base Nipple Areola o Extends from 2nd to 6th ribs. o It extends from the lateral margin of sternum medially to the midaxillary line laterally. o It has no capsule. o It lies on 3 muscles: • 2/3 of its base on (1) pectoralis major* Extra muscle, • inferolateral 1/3 on (2) Serratus anterior & (3) External oblique muscles (muscle of anterior abdominal wall). o Its superolateral part sends a process into the axilla called the axillary tail or axillary process.
    [Show full text]
  • 12. Development of Axial Skeleton and Extremities. Muscles and Skin
    Z. Tonar, M. Králíčková: Outlines of lectures on embryology for 2 nd year students of General medicine and Dentistry License Creative Commons - http://creativecommons.org/licenses/by-nc-nd/3.0/ 12. Development of axial skeleton and extremities. Muscles and skin. Timeline − 19 days: somites emerge in the gastrula − 4 weeks: sclerotome cells migrate along the neural tube − 5 weeks: mesenchymal blastema of the axial skeleton − 6 weeks: mesenchymal blastema of limbs − 8 weeks: rotation of the limbs − 8 weeks: individual muscles differentiate − 10 weeks: primary ossification centres in diaphyses − 3 months: bones of the skull develop − 9 months: diaphyses ossified; secondary ossification centres emerge In general, bone tissue originates from: − the of the somitic paraxial mesoderm, namely from the ventromedial part, the sclerotome − the head non-segmented mesoderm − the somatopleuric lateral plate mesoderm skeleton of limbs − the neural crest, which differentiates into the head ectomesenchyme − mesenchyme o its cells migrate and differentiate into fibroblasts, the source of the desmogenous (intramembranous) ossification o its cells imgrate and differentiate into chondroblasts, the source of the chondrogenous ossification of the hyaline cartilage models Limbs − week 4: limb buds o somatopleuric mesenchyme differentiates into bones and connective tissues o myogenic cells, angioblasts and nerves grow in o surface ectoderm thickens into the apical ectodermal ridge − week 6: each limb is divided proximodistally into three components: o autopod
    [Show full text]
  • Overview of the Breast - Breast Cancer | Johns Hopkins Pathology (En-US)
    12/11/2018 Overview of the Breast - Breast Cancer | Johns Hopkins Pathology (en-US) Overview of the Breast BREAST CANCER HOME > BREAST BASICS > OVERVIEW OF THE BREAST Learn about the normal anatomy of the breast. Anatomy & Physiology of the Breast https://pathology.jhu.edu/breast/basics/overview 1/4 12/11/2018 Overview of the Breast - Breast Cancer | Johns Hopkins Pathology (en-US) The breast is an organ whose structure reects its special function: the production of milk for lactation (breast feeding). The epithelial component of the tissue consists of lobules, where milk is made, which connect to ducts that lead out to the nipple. Most cancers of the breast arise from the cells which form the lobules and terminal ducts. These lobules and ducts are spread throughout the background brous tissue and adipose tissue (fat) that make up the majority of the breast. The male breast structure is nearly identical to the female breast, except that the male breast tissue lacks the specialized lobules, since there is no physiologic need for milk production by males. Anatomically, the adult breast sits atop the pectoralis muscle (the "pec" chest muscle), which is atop the ribcage. The breast tissue extends horizontally (side-to-side) from the edge of the sternum (the rm at bone in the middle of the chest) out to the midaxillary line (the center of the axilla, or underarm). A tail of breast tissue called the "axillary tail of Spence” extend into the underarm area. This is important because a breast cancer can develop in this axillary tail, even though it might not seem to be located within the actual breast.
    [Show full text]
  • Case Report Fibroadenoma in Ectopic Breast Tissue Mohammed EH Azoz Mass for One Year
    Case Report Fibroadenoma in ectopic breast tissue: a case report Mohammed EH Azoz ,MD*,Abdalla E Abdalla, MSc**, Mutaz M Elhassan, MD*** Department of Surgery*, Department of Anatomy**, Department of Pathology*** Kosti Teaching Hospital, Faculty of Medicine, University of El Imam El Mahdi-Kosti, Sudan. ورم ﻏﺪي ﻟﻴﻔﻲ ﻓﻲ ﻧﺴﻴﺞ ﺛﺪﻳﻲ إﺿﺎﻓﻲ ، دراﺳﺔ ﺣﺎﻟﺔ ﻣﺤﻤﺪ اﻟﺘﻮم ﺣﺎﻣﺪ ﻋﺰوز: اﺳﺘﺸﺎري اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﺔ. ﻋﺒﺪاﷲ اﻷﻣﻴﻦ ﻋﺒﺪاﷲ : ﻣﺤﺎﺿﺮ ﻋﻠﻢ اﻟﺘﺸﺮﻳﺢ. ﻣﻌﺘﺰ ﻣﺤﻤﺪ اﻟﺤﺴﻦ : اﺧﺘﺼﺎﺻﻲ ﻋﻠﻢ اﻷﻣﺮاض. اﻟﻤﻠﺨﺺ: آﺜﺮة اﻷﺛﺪاء ، وﻳﺴﻤﻰ أﻳﻀﺎً زﻳﺎدة ﻋﺪد اﻷﺛﺪاء أو اﻟﻨﺴﻴﺞ اﻟﺜﺪﻳﻲ اﻹﺿﺎﻓﻲ، وﻳﻌﺮف ﺑﺄﻧﻪ وﺟﻮد أآﺜﺮ ﻣﻦ ﺛﺪﻳﻴﻦ ﻣﻊ أو ﺑﺪون اﻟﺤﻠﻤﺔ واﻟﻬﺎﻟﺔ ﻓﻲ اﻟﺒﺸﺮ. هﺬا اﻟﺘﻘﺮﻳﺮ ﻋﻦ ﺣﺎﻟﺔ ﻓﺘﺎة ﻋﻤﺮهﺎ 24 ﺳﻨﺔ، ﺣﻀﺮت وهﻲ ﺗﺸﻜﻮ ﻣﻦ ورم ﺗﺤﺖ ﺟﻠﺪ اﻹﺑﻂ اﻷﻳﻤﻦ و ورم ﻓﻲ اﻟﺜﺪي اﻷﻳﺴﺮ ﻟﻤﺪة ﺳﻨﺔ. أُﺧﺬت ﺧﺰﻋﺔ وأﻇﻬﺮت ﻣﻼﻣﺢ ورم ﻏﺪي ﻟﻴﻔﻲ ﺗﺤﺖ ﺟﻠﺪ اﻹﺑﻂ اﻷﻳﻤﻦ واﻟﺜﺪي اﻷﻳﺴﺮ. ﺧﻀﻌﺖ اﻟﻤﺮﻳﻀﺔ ﻟﺠﺮاﺣﺔ اﺳﺘﺌﺼﺎﻟﻴﺔ ﻟﻠﻮرﻣﻴﻦ. وأﻇﻬﺮ اﻟﻔﺤﺺ اﻟﻨﺴﻴﺠﻲ ﻟﻠﻌﻴﻨﺘﻴﻦ اﻟﻤﺴﺘﺄﺻﻠﺘﻴﻦ ورم ﻏﺪي ﻟﻴﻔﻲ ﻓﻲ آﻠﺘﻴﻬﻤﺎ. Abstract along the primitive embryonic milk lines, Polymastia, also known as supernumerary or which extends from the axilla to the groin, and accessory breast, is defined as the presence of may occur unilaterally or bilaterally(1). more than two breasts with or without a nipple Axillary breast tissue is a common variant of and areola in human beings. We report a case EBT, with a reported incidence of 2 to 6% in of a 24-year-old female presented with right women(2). It is twice as common in females as axillary subcutaneous swelling and left breast in males(3). It can be seen during or before swelling for one year.
    [Show full text]
  • Carcinoma of the Axillary Tail of Spence: a Case Series
    ANTICANCER RESEARCH 32: 4057-4060 (2012) Carcinoma of the Axillary Tail of Spence: A Case Series FEDERICO AMPIL, GLORIA CALDITO, BENJAMIN HENDERSON, BENJAMIN LI, ROGER H. KIM, GARY BURTON and QUYEN CHU Louisiana State University Health and Feist-Weiller Cancer Center, Shreveport, LA, U.S.A. Abstract. There is sparse information about cancer in the reports. This audit of cases is an Institutional Review Board- axillary tail of Spence (CATS). Eight hundred and thirty-nine approved outcome study. For the purpose of this report, CATS patients with breast cancer were retrospectively studied for represented tumors situated in the axillary tail of Spence (SEER the occurrence of CATS. Ten patients were identified based code 50.6) and were reported as Breast Imaging Reported and Data System (2) /BI-RADS 4 or 5 abnormalities on mammographic on detection by imaging studies. A tendency towards stage II (Figure 1) and/or ultrasonographic imaging. or III disease, and estrogen and progesterone receptor- Patient follow-up time was measured from the date of breast negative neoplasms in the older age (>45 years) group was cancer diagnosis until death or last contact. Survival was estimated observed. Management by conservative or radical surgery, according to the product-limit method of Kaplan Meier. with or without postoperative radiotherapy and chemotherapy, effected an estimated five-year disease-free Results survival rate of 67%, and rates of local failure, regional recurrence as well as distant metastasis of 0%, 10% and The mean age was 55.2 years (range 44-79 years) and the 30%, respectively. The treatment of CATS in accordance with majority (7/10) of patients were over 45 years old.
    [Show full text]
  • An Organotypic Assay for the Quantification and Characterization of Regenerative Primary Human Mammary Epithelial Cells
    Aus dem Helmholtz Zentrum München Institut für Stammzellforschung Direktorin: Prof. Dr. Magdalena Götz An organotypic assay for the quantification and characterization of regenerative primary human mammary epithelial cells Dissertation zum Erwerb des Doktorgrades der Naturwissenschaften an der Medizinischen Fakultät der Ludwig-Maximilians-Universität München vorgelegt von Jelena Linnemann aus Bielefeld 2017 Gedruckt mit Genehmigung der Medizinischen Fakultät der Ludwig-Maximilians-Universität München Betreuerin: Prof. Dr. Magdalena Götz Zweitgutachter: Prof. Andreas Ladurner, Ph.D. Dekan: Prof. Dr. med. dent. Reinhard Hickel Tag der mündlichen Prüfung: 19.12.2017 Within the scope of the present PhD thesis, the following original article has been published in an international peer reviewed journal: Linnemann, J.R., Miura, H., Meixner, L.K., Irmler, M., Kloos, U.J., Hirschi, B., Bartsch, H.S., Sass, S., Beckers, J., Theis, F.J., Gabka C., Sotlar K. and Scheel C.H. (2015). Quantification of regenerative potential in primary human mammary epithelial cells. Development, DOI:10.1242/dev.123554. Abstract Breast cancer is a heterogeneous disease with a high degree of intra- and intertumoral diversity, which impedes accurate patient stratification, prognosis and optimal treatment. The mammary gland consists of a complex network of epithelial ducts which end in clusters of alveoli, called terminal ductal lobular units (TDLUs) which are the functional units of the mammary gland. Postnatal mammary gland development and homeostasis require an enormous regenerative output, suggesting the existence of tissue stem/progenitor cells and a high degree of cellular plasticity to ensure functional robustness, i.e. the production and secretion of milk during lactation. Therefore, the observed heterogeneity in breast cancer is likely the result of normal mammary gland architecture and functionality.
    [Show full text]
  • Bilateral Accessory Breast S Sahu, M Husain, P Sachan
    The Internet Journal of Surgery ISPUB.COM Volume 17 Number 2 Bilateral Accessory Breast S Sahu, M Husain, P Sachan Citation S Sahu, M Husain, P Sachan. Bilateral Accessory Breast. The Internet Journal of Surgery. 2007 Volume 17 Number 2. Abstract Accessory breasts or polymastia occur in 0.4-6 per cent of women and 1-3% of males. They can consist of any or all components of the breast and may be functional or non-functional. Approximately 67% of accessory breast tissue occurs in the thoracic or abdominal portions of the milk line, often just below the inframammary crease and more often on the left side of the body. Another 20% occur in the axilla. We report a case of bilateral axillary accessory breast. Excision was done under general anesthesia. INTRODUCTION Figure 1 The mammary glands are a distinguishing feature of Figure 1: Bilateral Axillary Accessory Breast mammals beginning their development early in the embryologic life. At 5 weeks of embryologic development, ectodermal mammary streaks extend bilaterally from axilla to groin. Two weeks later, a mammary ridge or milk line develops in the thoracic portion of the primitive streaks and begins to proliferate as a primary mammary bud. This primary bud subsequently begins growth downward as a solid diverticulum into the underlying dermis during the seventh week. By the 10th week, the primary bud begins to branch, yielding secondary buds by the 12th week, which eventually develop into the mammary lobules of the adult breast. Further differentiation into complete breast parenchyma occurs during the remainder of gestation. The remainder of the mammary streak usually regresses; however, incomplete involution can result in foci of accessory breast tissue anywhere along the line that extends from axilla to groin.
    [Show full text]
  • NORTH – NANSON CLINICAL MANUAL “The Red Book”
    NORTH – NANSON CLINICAL MANUAL “The Red Book” 2017 8th Edition, updated (8.1) Medical Programme Directorate University of Auckland North – Nanson Clinical Manual 8th Edition (8.1), updated 2017 This edition first published 2014 Copyright © 2017 Medical Programme Directorate, University of Auckland ISBN 978-0-473-39194-2 PDF ISBN 978-0-473-39196-6 E Book ISBN 978-0-473-39195-9 PREFACE to the 8th Edition The North-Nanson clinical manual is an institution in the Auckland medical programme. The first edition was produced in 1968 by the then Professors of Medicine and Surgery, JDK North and EM Nanson. Since then students have diligently carried the pocket-sized ‘red book’ to help guide them through the uncertainty of the transition from classroom to clinical environment. Previous editions had input from many clinical academic staff; hence it came to signify the ‘Auckland’ way, with students well-advised to follow the approach described in clinical examinations. Some senior medical staff still hold onto their ‘red book’; worn down and dog-eared, but as a reminder that all clinicians need to master the basics of clinical medicine. The last substantive revision was in 2001 under the editorship of Professor David Richmond. The current medical curriculum is increasingly integrated, with basic clinical skills learned early, then applied in medical and surgical attachments throughout Years 3 and 4. Based on student and staff feedback, we appreciated the need for a pocket sized clinical manual that did not replace other clinical skills text books available. Attention focussed on making the information accessible to medical students during their first few years of clinical experience.
    [Show full text]