Health for Self Newsletter

This post is the first in a set of three posts covering the topic of breast cancer.  The first post will deal with the basic anatomy of the breast and also benign (or non-cancerous) processes that occur in the breast. The second post will deal with malignant diseases of the breast.  The series will conclude with current treatments for breast cancer.

Basic Breast Anatomy:

The breast lies between the second and sixth rib, with tissue extending to the axilla (scientific name for the armpit). The breast lies on top of the chest muscles known as the pectoralis major and pectoralis minor.  The breast contains fat tissue, connective tissue, lymphatics, nerves, and blood vessels.  The blood supply  to the breast is through the internal mammary artery and lateral thoracic arteries.  The lymphatics of the breast drain to the axilla in 97% of cases.  This is an important fact in regards to malignancy (will be discussed furth in the second post of this series).  The long thoracic nerve is important as it provides nerve impulses to the serratus anterior and subscapularis muscles.  This is a very important nerve in breast surgery, as if the long thoracic nerve is damaged, it can cause a winged scapula (droopy shoulder blad) and a weakend shoulder.

The breast is also composed of what are known as ducts and lobule structures.  The tunnel-like structures that lead toward the nipple are “ducts.”  The round structures that branch off the ducts are known as “lobules.”

 Benign Diseases:

Most masses of the breast are either discovered during routine screening, such as mammogram screenings, or felt by the individual as a mass or lump in the breast.  Microcalcifications are most frequently seen on mammograms as abnormalities.  Cysts can also present as abnormal findings during exams.

Cysts:  These are cavities that are often fluid filled and develop in about 7% of women.  The easiest way to analyze a cyst is to take a needle and draw out the fluid within the cysts.  If the fluid is bloody, the cyst is solid, or the cyst recurs quickly, then a biopsy is most likely warranted to further evaluate the cyst.  If the fluid is clear and the cyst does not occur again, it is probably a benign process.

Fibroadenoma: These are the most common cause of a mass found in women 25 years of age and younger.  Though it is very rare to for a fibroadenoma to be malignant, it is still necessary to perform a biopsy in these masses, regardless of the patient’s age.  Biopsy can be performed using a needle to obtain some tissue, or the entire mass can be removed during a minor surgical procedure.  Usually, nearly 60% of these masses will decrease in size and 35% will not change in size at all.

Fat Necrosis:  Typically occur after a surgical procedure or trauma to the breast.  They occur if bleeding into the breast tissue occurs.  A round, firm mass will form in the breast as the bloody area heals.  This is typically a benign process but further analysis is needed to ensure a malignant process is not occuring.

Mondor Disease:   Due to inflammation of the veins found in the breast tissue close to the skin.  Women will tend to have pain in the breast and even some dimpling of the skin.  In these cases, a mammogram is recommended.  The disease will usually go away with time.  However, if the pain and inflammation persists, removal of the vein can be performed.

Next Post: Malignant Disease of the Breast

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