Anatomy of Breast

Varun Ram
Serial No. 13
• Breast is a modified sweat (apocrine) gland, which is present b/l over
the pectoral region in both sexes
• In males, it is rudimentary
Location and Extent
• Situated mostly within the superficial fascia of the pectoral region
• A small projection known as the axillary tail of Spence penetrates the
axillary fascia laterally and lies within the deep fascia of the axilla.
• The axillary tail of Spence enters the deep fascia through the Foramen
of Winslow.
• Extent:
• Vertcally: From second to sixth rib in the mid clavicular line.
• Horizontally: From lateral border of sternum to the mid-axillary line along the
fourth rib.
Relations
• The base of the mammary gland also, called mammary bed rests
upon the following structures (from superficial to deep):
• Retromammary space
• Deep fascia (pectoral fascia)
• Muscles- pectoralis major, serratus anterior, external oblique
• Retromammary space: A space deep to the base of the gland, lies
superficial to deep fascia. Contains loose areolar tissue, makes the
gland freely movable.
Structure
• Presenting Parts:
• Nipple: Conical projection in the centre of the anterior part of the breast, lies
in the fourth intercostal space, has openings of 15-20 lactiferous ducts.
• Areola: circular pigmented area of skin around the base of the nipple,
contains modified sebacious glands.
• Inner Structure:
• Fibrous tissue: Supports the gland. Forms septa (suspensory ligaments of
cooper) which anchors the gland to the overlying skin and to the underlying
deep fascia (pectoral fascia), and divides the gland into 15-20 lobes.
• Glandular tissue:
• Consist of 15-20 lobes.
• Lobes are of tubuloalveolar type.
• Each lobe has one lactiferous duct. Lobes are arranged in a radiating manner
arround the areola. The lactiferous duct dilates near its opening in the nipple
to form lactiferous sinus which act as reservoir of milk.
• Ducts are surrounded by myoepithelial cells.
Neurovascular Supply
• Arterial Supply:
• Axillary artery- lateral thoracic branch and superior thoracic branch.
• Internal thoracic artery- perforating branch
• Posterior intercostal artery (2nd , 3rd, 4th )- lateral branch.
• Venous Drainage: Veins form an anastomotic venous circular plexus
arround the mammary gland. Veins from this plexus ends in axillary,
internal thoracic and posterior intercostal veins.
• Nerve Supply: Intercostal nerves (4th- 6th )- anterior and lateral
cutaneous branches.
Lymphatic Drainage
Lymph Nodes
• Axillary: Majority of drainage (75%)
• Anterior group
• Posterior group
• Central group
• Apical group
• Lateral group
• Internal mammary (parasternal) nodes, which lie along internal
thoracic vessels. Drains about 20% of total.
• Supraclavicular nodes, posterior intercostal nodes, subdiaphragmatic
and subperitoneal nodes.
Lymphatics
• Superficial Lymphatics: Drain the skin over breast except nipple and
areola. Lymphatics pass radially to the surrounding nodes.
• Deep Lymphatics: Drain the parenchyma of the breast, along with the
nipple and areola.
• There are superficial lymphatic communications between the breasts
across the midline.
Thank You