Breast/ Mammary Gland

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BREAST/ MAMMARY GLAND Modified sweat gland Accessary organ of reproductive system & well developed after puberty in female Provides milk to the newborn SITUATION Superficial Axillary tail ( of spence ) in Axilla EXTENT • Vertical : 2 nd -6th rib • Horizontal :-lat. Bor.of sternum –Mid axillary line DEEP RELATIONS • Retromammary space • Pectoral fascia • Pectoralis major, Serratus anterior, External oblique abdominis • Clavipectoral fascia,Pectoralis minor •2nd –6th rib & 2nd –5th intercostal space with its contents STRUCTURE OF BREAST • SKIN Nipple & Areola (no hair &fat) • PARENCHYMA(15-20 lobes) lactiferous duct- l.sinus –alveolus • STROMA Fibrous(suspensory ligament) Fat BLOOD SUPPLY Arterial:supply from ant. Surface (post. Avascular) • Perf. Branches of int. thoracic art. • Branches of lat. Thoracic, superior thoracic, acromio thoracic(thoraco acromial) • Lat. Branches of post.intercostal art. VENOUS DRAINAGE • Follows the arteries • Converge towards the base of the nipple & forms an anastomotic v. circle • Venous circle S/F • I.TH., LOW. PART OF NECK • DEEP- I.TH.,AXILLRY,P.INTERCOSTAL LYMPHATIC VESSELES • S/F –SKIN EXCEPT NIPPLE &AREOLA • DEEP- PARENCHYMA + NIPPLE & AREOLA LYMPH NODES • AXILLARY L. N. - ANT. (CHIFLY) (75%) -POST. -LAT. -CENTRAL -APICAL • PARASTERNAL(INTERNAL MAMMARY) L.N. ( 20%) • SUPRACLVICULAR,DELTOPECT ORAL,POST. INTERCOSTAL,SUBDIAPHRAGM ATIC,SUBPERITONEAL (5%) APPLIED ANATOMY (CARCINOMA & ABSCESSES) • INCISIONS- RADIALLY (avoid cutting lactiferous ducts ) • BREAST FIXED –(cancer cells infiltrate the suspensory ligaments ) • RETRACTION OR PUCKERING OF THE SKIN – (contraction of ligaments due to cancer cells ) • RETACTION OF NIPPLE – infiltration of lactiferous ducts & consequent fibrosis APPLIED ANATOMY (CARCINOMA & ABSCESSES) • PEAUD’ ORANGE APPEARANCE –obstruction of s/f lymph vessels • METASTASIS TO OTHER BREAST –s/f lymphatics communicate across the midline • METASTASIS TO LIVER & PELVIS-communication with abdomen • METASTASIS TO VERTEBRAE & BRAIN –veins communicate with the vertebral venous plexus of veins ) .

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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.
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