1. UNIVERSIDAD DE GUADALAJARA
CENTRO UNIVERSITARIO DE CIENCIAS DE LA SALUD
BREAST
Dr. Benjamín Robles Mariscal
Dr. Héctor Manuel Virgen Ayala
Clínicas Quirúrgicas
Brenda de la Torre Aguayo
209340718
MCPA

2. The normal breast
ANATOMY

3. A “teardrop” shape
The asymmetry is common
Vascular supply:
medial and central portion:
perforating branches from the internal
mammary artery
laterally
lateral thoracic
fascial envelope
Suspensory ligaments of Cooper

5. Histology
Breast tissue
has two histologically distinct tissues: lobular
& ductal
The lobule
-is the functional unit of the breast
Alveoli are terminal elongated tubular ducts
Around 10-100 alveoli coalesce to form larger
lobular ductal units

6. BENIGN BREAST DISORDERS

7. Fibrocystic disease
• Refers to women with severely symptomatic
breast
Radiographic
• S&S
• Mastodynia Clusstered
• Breast masses micricalcifications
• Nipple discharge on MMG
Treatment
Reassurance

9. Fibroadenoma
It is the most common breast common tumor in
adolescents and young women
Patients will have multiple fibroadenomas in
10% -15% of cases

10. Characteristics
A painless, slow growing mass found on self-
breast examination
Several cm.
Changes with mestrual cycle
Well circumscribed
Diagnosis
Firm rubbery texture MMG popcorn
calcification when
degeneration
Ultrasound evaluation

12. Treatment
Based on probability of missing a primary breast
CA
-30. observation
Removal if enlarges
+30 FNA
Surgery indicated in changes

13. Giant fibroadenomas
+ 5 cm

14. Radial scar
Radial sclerosing lesions
In MMG shows a stellate, irregular spiculated
mass lesion
A tissue diagnosis is required to differentiate
from cancer

16. Fat necrosis
Inflamatory necrosis related to trauma
Macrophages laden with fat lobules. Or foreign
body giant cells
Treatment
Involves reassurance without excision

18. Periductal mastitis
Uncommon disease
dilated mammary ducts with inspissated
secretions and marked periductal inflammation
S&S
include noncyclicla mastodynia; nipple
retraction; thick, white creamy nipple discharge; as
sterile subareolar abscesses.
History Treatment
Difficulty with breast-feeding Reassurance
Surgical incision and
drainage

20. Infectious mastitis
80% are associated with breast-feeding
The most common pathogen is Staphylococcus
aureus
Nonlactating women
chronic infections (actinomycosis, tb, syphilis)
autoimmune diseases (lupus erythematosus)
Most infections
begin as skin cellulitis
may be treated with antibiotics safe for feeding the
infant

22. Galactoceles
Are breast cysts that are filled with milk
Almost exclusively seen after breast-feeding and
represent silated obstructed breast ducts
Treatment
Ranges from simple aspiration to surgical
incision and drainage

24. Mondor s disease
Trombophlebitis of superficial veins of the breast
This affects the lower outer quadrant, presents as
a pakoable, cord-like mass, burning pain
Treatment
NSAIDs

26. Intraductal papilloma
Most common cause of bloody nipple discharge
Lesions: small, nonpalpable, close to the nipple
Dx. Ductography
Tx. Subareolar excision

28. Nipple discharge
Bloody: intraductal papilloma & breast ca
Purulent: subareolar infection
Milky white: galactorrhea
Green/yellow or brown: fibrocystic disease

29. Mastodynia
2 types
Cyclie mastodynia
Continuous mastodynia
Tx
NSAIDS
Changes in life style