🔺Breast :
-Extend-upward to 2rib
-Extend downward at 6rib
-Medially:lateral border of sternum
-Laterally:anterior Axillary line
-Breast rest on :
· Pectoralis major
· External oblique muscle(Inferior medially )
·Serratus anterior muscle (Inferior laterally )
🔺Blood supply to breast :
1. Internal mammary artery
2. Intercostal artery
3. Thoraco acromial artery
4. Lateral thoracic artery
🔺Lymphatic drainage :
1. Axillary lymph node (MC 85%)
2. Internal mammary LN
3.Peritoneal lymphatic plexus in rectus sheath
🔺Congenital breast disease:
1. Athelia
2. Polythelia
3. Amazia
4. PolyMazia
5. Poland syndrome (Amazia and No pectoralis major)
🔺Breast trauma :
1. Fat necrosis (Hard mass ,Painless ,associated with nipple retraction )
2.Breast haematoma (Hard mass ,painless, associated with nipple retraction)
Differentiated from Cancer by biopsy
🔺Acute lactational mastitis
· Due to staphylococcus aureus
· Milk engorgement
· Abrasion to nipple due to suckling
· Poor hygiene
◽️Sign :
· Dull aching pain
· Hotness and redness
· Higher pyrexia
· Tenderness
Form abscess ➡️Throbbing pain
◽️ttt ➡️Antibiotics /Incisional and drainage of abscess
🔺Duct ectasia(Plasma cell mastitis ):
· Abnormal dilation of major duct of breast
· Nipple discharge: purulent (yellow,brown, green )
· Nipple retraction
· Periductal abscess
· Mammary fistula
· ttt➡️ Excision and biopsy
🔺Fibrocystic disease of breast (ANDI) (Fibroadenosis)(Mammary dysplasia )
· Most frequent breast disorder
·Multiple,psinful,small lump ,in relation to MC
· Nipple discharge (Yellow or clear )
· Mastalgia
·Ttt: Aspiration of cyst /NSAID/antiestrogen /Androgen
◽️Benign lesion :
1.Intraductal papilloma
· Blood nipple discharge
· Retro areolar mass
2. Fibroadenoma :
· Commonest breast mass of young 🚺
· 15-30y
· Painless lump
· Small
· Non tender
·Firm will circumscribe
· High mobility within breast (Breast mouse)
·ttt➡️Excision
3.Phylloid’s tumor (Brodie’s sarcoma )
·Rare condition
· Slow grow swelling
·Large in size
·Skin necrosis and ulceration
🔺Risk factor of Breast cancer :
1.Genatic BRCAI /BRCAII
2.Family history
3.Age
4.Early menarche
5.Late menopause
6. Unmarried
7.Nullipara
8.Non lactating
9.Long use of OCP
10. Exposure to radiation
11. Alcohol consumption
12. Cigarette smoking
13. Obesity
🔺Symptoms and sign of Malignant lesion :
· Painless lump ,Nipple retraction with blood discharge,Hard mass fixation to skin
· Skin dimpling
· Peu d’orang
· Skin nodule
· Skin ulceration
·Axillary and supraclavicular LN palpable
🔺Investigation:
1.Mammography
2.Ultrasound
3.Biopsy
· Fine needle aspiration
· True cut biopsy
· Frozen section biopsy
· Incisional biopsy
· Exesional biopsy
🔺Triple assessments:
1. Clinical examination
2. Radiological (X-ray ,USS)
3. Pathological (biopsy)
