A Family Doctor’s Tale – THE BREAST

The Breast

 

 

“Women are always complaining about men’s fascination with breasts. But what if men were absolutely indifferent to breasts? What would women do then with these things that serve one function once or twice in a lifetime, and the rest of the time are just in the way?”

- Jonathan Carroll

 

The breast generally refers to the mammary gland that secretes milk used to feed infants.

Both men and women develop breasts from the same embryological cells.

At puberty female sex hormones mainly estrogens promote breast development in girls.

This does not occur in men due to the higher amount of testosterone (male hormone)

 

As a result, women’s breasts become far more prominent than those of men.

In humans, the breasts develop at adolescence usually well before any pregnancy has occurred and the breasts stay enlarged throughout the remainder of life.

 

Anatomy of the breast:

 

In women the breast covers the pectoralis major muscle and usually extends from the level of the second rib to the level of the sixth rib in the front of the human rib cage.

The breasts cover much of the chest area and the chest walls.

 

Inside the mammary gland there is a complex network of branching ducts These ducts exit from sac-like structures called lobules. The breast ducts transport milk from the lobules out to the nipple. The milk exits the ducts from the breast at the nipple.

 

The lobules in the breast are the glands that can produce milk in females when they receive the appropriate hormonal stimulation.

 

The nipple becomes erect because of such stimuli as a cold environment, breastfeeding, and sexual activity. The purpose of the nipple of the post-partum female is to breastfeed the infant.

 

The small pigmented area around the nipple is called the areola. During pregnancy the areola darkens further and spreads in size. The areola contains small modified sweat glands that secrete moisture that acts as a lubricant for breastfeeding.

 

The lobules and ducts in the breast are supported by surrounding fatty tissue and the suspensory ligaments of the breast. There are no muscles in the breast. However, the breast tissue is located on top of the large chest muscles of the chest wall.

 

There are blood vessels and lymphatic vessels in the breast.

 

The lymphatic vessels are thin channels similar to blood vessels; they do not carry blood but collect and carry tissue fluid which ultimately re-enters the blood stream. Breast tissue fluid drains through the lymphatics into the lymph nodes located in the underarm and behind the breast bone.

 

When a woman or a man detects a breast lump, breast cancer is likely the main worry.

 

A breast lump in man is called gynecomastia. Breast cancer can also be found in men.

 

Most breast lumps are harmless (benign).

 

Nevertheless every breast lump should be examined by a doctor to exclude or establish a diagnosis of cancer.

 

Breast cancer is the most common cause of cancer in women

 

When detected early, breast cancer has a high cure rate.

 

It is therefore important breast cancer screening of women is done with regular mammograms.

 

A number of benign tumors and changes can also affect the breast to cause a lump.

 

Fibro adenoma is a common benign tumor of the breast that occurs in young women and is completely cured by surgical removal.

 

Other benign changes in the breast include fibrocystic changes and presence of benign cysts.

 

Infections of the breast known as mastitis are particularly common in women who are breastfeeding.

 

When the skin of the nipple is injured or cracked, such as occurs with breastfeeding, bacteria can enter the wound and cause infections.

 

Infections can either be a deep pocket of pus, in which the infection looks like it is growing down into the breast (an abscess), or a wider area of skin redness that spreads out.

 

Cosmetic surgeries are sometimes performed when women request breast reduction or breast augmentation.

 

Although different techniques are used, breast implants have been used for surgical breast enlargement.

 

Breast reconstruction is a cosmetic technique that is also commonly performed after surgical breast removal (mastectomy) for breast cancer.