Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Section 1 Basic Sciences Relevant to Surgical Practice
- Section 2 Basic Surgical Skills
- Section 3 The Assessment and Management of the Surgical Patient
- Section 4 Perioperative Care of the Surgical Patient
- Section 5 Common Surgical Conditions
- 16 Assessment and early treatment of patients with trauma
- 17 Fundamentals of the central nervous system
- 18 Fundamentals of head and neck surgery
- 19 Fundamentals of thoracic surgery
- 20 Oesophago-gastric surgery
- 21 Fundamentals of hepatobiliary and pancreatic surgery
- 22 Fundamentals of endocrine surgery
- 23 Fundamentals of the breast
- 24 Lower gastrointestinal surgery
- 25 Fundamentals of the genitourinary system
- 26 Hernias
- 27 Fundamentals of vascular surgery
- 28 Fundamentals of orthopaedics
- 29 Fundamentals of plastic surgery
- 30 Surgical care of the paediatric patient
- 31 Fundamentals of organ transplantation
- Index
23 - Fundamentals of the breast
Published online by Cambridge University Press: 03 May 2011
- Frontmatter
- Contents
- List of contributors
- Preface
- Section 1 Basic Sciences Relevant to Surgical Practice
- Section 2 Basic Surgical Skills
- Section 3 The Assessment and Management of the Surgical Patient
- Section 4 Perioperative Care of the Surgical Patient
- Section 5 Common Surgical Conditions
- 16 Assessment and early treatment of patients with trauma
- 17 Fundamentals of the central nervous system
- 18 Fundamentals of head and neck surgery
- 19 Fundamentals of thoracic surgery
- 20 Oesophago-gastric surgery
- 21 Fundamentals of hepatobiliary and pancreatic surgery
- 22 Fundamentals of endocrine surgery
- 23 Fundamentals of the breast
- 24 Lower gastrointestinal surgery
- 25 Fundamentals of the genitourinary system
- 26 Hernias
- 27 Fundamentals of vascular surgery
- 28 Fundamentals of orthopaedics
- 29 Fundamentals of plastic surgery
- 30 Surgical care of the paediatric patient
- 31 Fundamentals of organ transplantation
- Index
Summary
Basic biology
Anatomy of the breast
Embryology
The breast is a modified sweat gland which originates from the ectodermal layer of the embryo between the fifth and sixth week of gestation. It arises from the ‘milk lines’, which are two ridges of ectodermal thickening, running from the axilla to the groin. Although most of the ‘milk line’ eventually disappears, a prominent ridge remains in the pectoral area to form the breast. The ectoderm in this area subsequently grows into the underlying mesoderm as a series (15–20) of buds. These ectodermal buds, which are initially solid, eventually form the lactiferous ducts and their associated alveoli. The adjacent mesenchyme develops into the surrounding adipose and connective tissues. During the final two months of gestation, the ducts become canalized and a ‘mammary pit’ is formed in the ectoderm. The lactiferous ducts subsequently communicate with the mammary pit.
Gross anatomy
Morphological features
The breast is situated within the subcutaneous tissue of the anterolateral chest wall. It extends from the second to the sixth rib and from the edge of the sternum to the mid-axillary line, overlying the pectoralis major, serratus anterior, upper part of the rectus sheath and external oblique muscles. The breast extends in a supero-lateral direction along the border of the pectoralis major muscle, through the foramen of Langer in the deep fascia of the axilla, to lie close to the pectoral group of axillary lymph nodes. This is termed the axillary tail of Spence.
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- Chapter
- Information
- Fundamentals of Surgical PracticeA Preparation Guide for the Intercollegiate MRCS Examination, pp. 392 - 429Publisher: Cambridge University PressPrint publication year: 2011