Breast Anatomy and Biopsy Techniques Quiz

The breast is primarily a modified sweat gland developed from the embryonic ectoderm.

The mammary line extends from the armpit (axilla) to the groin (inguinal region), marking the potential location of breast tissue development.

Accessory breast tissue can appear anywhere along the mammary line, a result of incomplete regression of embryonic tissue.

The breast sits within the superficial fascia of the anterior chest wall, extending from the 2nd to 6th intercostal spaces, and from the lateral border of the sternum to the mid-axillary line.

The breast tissue extends into the anterior axillary fold, important for surgeons to consider during mastectomy.

The breast is composed of 15-20 lobes of glandular tissue responsible for milk production, supported by fibrous connective tissue (Cooper's ligaments), adipose tissue, blood vessels, nerves, and lymphatics.

Adipose tissue resides within the parenchyma between the lobes, contributing to the breast's size and shape.

The areola and nipple contain involuntary muscle fibers that contract for nipple erection (Sappeys muscle) and retraction (Myerholts muscle).

The areola is covered with sweat glands and sebaceous glands (Montgomery glands) which enlarge during pregnancy and lubricate the nipple during lactation.

A minimally invasive procedure that uses a thin needle to extract cells from a suspicious area. It's quick, cheap, and doesn't require a cut, but it cannot tell the difference between non-invasive and invasive cancer or check for certain breast cancer markers.

A type of biopsy that removes a small piece of tissue for examination. It's more in-depth than FNA, can distinguish between types of cancer, and can be used to check for specific breast cancer markers.

A procedure that utilizes a larger needle to extract a core of tissue for examination. It's performed under local anesthesia and image guidance, and is commonly used for breast tissue.

A comprehensive approach to diagnosing breast problems involving 3 key components: physical examination, imaging (mammography and ultrasound), and FNAC. It's more accurate than any single component alone.

An imaging technique that uses sound waves to create images of the breast. It's especially useful for detecting abnormalities in dense breast tissue.

The most common and effective imaging technique for screening for breast cancer in women over 40. It uses low-dose X-rays to detect subtle changes in breast tissue.

The medial mammary arteries, branches of the internal thoracic artery, supply blood to the medial part of the breast. They are assisted by perforating branches from the second, third, and fourth intercostal arteries, contributing to the overall blood supply of the breast.

Breast veins follow the same path as the arteries, draining into the axillary, internal thoracic, and second to fourth intercostal veins.

The complex network of lymphatic vessels in the breast plays a crucial role in draining fluid and potentially cancer cells. Contrary to previous belief, lymphatic plexuses are not the primary route, but instead, lymphatic vessels accompany major blood vessels to reach the following lymph nodes.

75% of lymphatic drainage from the breast flows to the axillary lymph nodes, primarily to the pectoralis, central, and apical groups.

20% of lymphatic drainage from the breast reaches the internal mammary lymph nodes.

5% of breast lymphatic drainage flows to supraclavicular, infraclavicular, subscapular, and intercostal lymph nodes.

The axillary lymph nodes are grouped into five main categories: Anterior (pectoral), Posterior (subscapular), Lateral (humeral), Central, and Apical.

The surgical classification of axillary lymph nodes divides them into three levels:

1. Above the pectoralis minor: Apical and infraclavicular nodes.
2. Deep to the pectoralis minor: Central group.
3. Below the pectoralis minor: Anterior, posterior, and lateral groups.

Mammography is a low-voltage, high-amperage X-ray technique specifically designed for soft tissue imaging. It uses a relatively safe dose of radiation (1mGy per film) to detect breast abnormalities.

Ultrasound is particularly useful in young women with dense breasts where mammography may be challenging to interpret. It also aids in differentiating cysts from solid breast lesions.