Anatomy of Breast

BY
Dr. Farida
 Gross Anatomy of Breast

 Milk producing glands

 2nd to 6th ribs
 Fat & variable amount of glandular tissue
 Surrounded by fascia of chest wall—Cooper’s
ligament
Gross Anatomy

Breast profile:
A. ducts
B. lobules
C. dilated section of
duct to hold milk
D. nipple
E. fat
F. pectoralis major
muscle
G. chest wall/rib cage
Gross Anatomy of Breast
Radiological Anatomy Of Breast

• Mammography
• Ultrasonography
• Magnetic resonance imaging
Mammography

 X-rays were first used to examine the breasts

more than 90 years ago. But modern
mammography has only existed since the
late 1960s, when the first x-ray machines
used just for breast imaging became
available. Since then, the technology has
advanced a lot, and today's mammogram is
very different even from those of the mid-
1980s.
Technique

 Mammography is a special type of x-ray imaging

uses low dose x-ray; high contrast, high-
resolution film; and an x-ray system designed
specifically for imaging the breasts.
 Plastic& Xray plates
 Plain xray or electronic films are taken.
Mammography

 Screening mammography is an x-ray examination

of the breasts in a woman who is asymptomatic . The
goal of screening mammography is to detect cancer
when it is still too small to be felt by a woman or her
physician.
 Diagnostic mammography is an x-ray examination
of the breast in a woman who either has a breast
complaint or has had an abnormality found during
screening mammography.
 Followed by ultrasound & breast biopsy
Mammographic Machine
Mammogram
Mammogram
Mammogram
Ultrasonography of breast

• Reveals detailed anatomy of breast including

areas adjacent to chest wall which is hard to
study with a mammogram.
• Solid or cystic nature of breast lump
• Countercheckabnormal results from a
mammogram.
• For youngwoman breast tissue
• Localize site of biopsy/guided breast surgery
.
Sonogaphic Anatomy

Cartilaginous rib
 Transverse section of rib
 Pectoralis major muscle
Sonogaphic Anatomy

 Cartilaginous rib
Transducer was rotated
perpendicular to its
location in A shows
long axis of structure
(r), confirming its
identity as rib.
Sonographic Anatomy

• Inverted nipple mimics

appearance of ill-
defined markedly
hypoechoic mass.
posterior acoustic
attenuation is present
because of dense
connective tissue and
smooth muscle bundles
comprising nipple
Sonographic Anatomy

 Normal fat lobule

isoechoic solid mass .
Sonogram obtained in
radial plane reveals
circumscribed isoechoic
mass (m) separated
from surrounding
adipose tissue
Sonographic Anatomy

 Normal fat lobule

 isoechoic solid mass
transducer was rotated
90° into antiradial plane
shows mass apparent
in A "merged" with
surrounding fat tissue,
confirming identity of
structure as fat lobule.
Sonographic Anatomy

Lactiferous Duct
15 and 20 lactiferous ducts
• 3 mm in diameter,
• Dilated duct may mimic a small cyst.
• To avoid misidentification of tubular or elongated
structures, imaging should always be performed in
both radial and antiradial planes.
Sonographic Anatomy

 Acoustic shadowing
from Cooper's
suspensory ligament
between normal fat
lobules.
Sonographic Anatomy

 Acoustic shadowing
from Cooper's
suspensory ligament
resolved after mild
pressure application to
transducer.
Sonographic Anatomy

 Poor transducer—skin
contact mimics
suspicious acoustic
shadowing
Sonographic Anatomy

 Acoustic gel applied to

skin reveals that
apparent lesion and
parallel echogenic lines
have resolved.
Sonographic Anatomy of Breast
MRI Of Breast

Magnetic Resonance Imaging (MRI) of the

breast is a painless diagnostic procedure that
uses magnets and computers to create
pictures or images of areas inside the body.
MRI Of Breast

 MRI is evolving &increasingly popular

imaging modality
 Can be performed on all standard whole body
magnets @field strength of 0.5T-1.5Tesla.
 Thin slices are taken to assure absence of
partial volume effects
 Imaging should be performed with spatial
resolution in plane < than 1mm.
Comparison of MRI &
Mammography
 MRI is sensitive than mammography
 Better for dense breast tissue of younger
females
 Calcifications
 False positive results
 Expensive
 Formal practical standards
Coronal MRI Breasts

 T1 weighted MR image
of the breasts.
Coronal MRI Breasts

 T1 weighted MR image
of both breasts with
contrast.
Coronal MRI Breasts

 T2 weigthed MR image
of both breasts
Coronal MRI Breasts

 T1 weighted MR image
of both breasts
Breast MRI: Fibroadenoma (Benign

Pre-contrast  Post-contrast
Breast MRI: Ductal Carcinoma In Situ

 Pre-contrast  Post-contrast
Breast MRI: Invasive Carcinoma
(2.5 cm tumor with microfoci of DCIS)

 Pre-contrast  Post-contrast
Breast MRI: Bloody Nipple Discharge

Pre-contrast  Post-contrast
Breast MRI: Implants

Extracapsular rupture,  Bubble in implant,

lower upper
Breast MRI: Metal Artifact
(Surgical Clip)
 Pre-contrast  Post-contrast
Breast MRI: Lactating Breast
(No contrast agent used
THANKS