Breast is a paired organ located on the anterior surface chest on both sides of the midline and extending from the III to VII ribs and from the parasternal line to the anterior axillary line (Balboni et al., 2000).
The volume, shape and level of development varies from many factors, such as age, the degree of development of glandular tissue, the amount of adipose tissue, work endocrine system. Before puberty the area of the mammary gland has a flat shape, but in the process of puberty it acquires the shape of a hemisphere. The shape of the breast can vary from conical and spherical to pear-shaped or discoid. (Testut and Latarjet, 1972).
The nipple is located in the center of the mammary gland, surrounded by the areola. The areola is a hyperpigmented area of the skin of a round or oval shape, its diameter varies from 3.5 to 6 cm. The nipple is located in the center of the areola and also varies in size and shape (conical, cylindrical). At its top there are several recesses representing the outlets of the excretory ducts. The surface of the areola is uneven due to 8-12 tubercles of Morgagni, which are sebaceous glands.
The mammary gland consists of glandular, adipose and fibrous tissues. Functionally, it is an apocrine sweat gland modified for feeding. The glandular tissue is represented by 15-20 lobes with irregular radial orientation around the nipple (Testut and Latarjet, 1972). Each lobe is an independent functional unit consisting of small lobules represented by secreting units - alveoli. The alveolar ducts merge into the lobular ducts, which in turn merge into the lactiferous ducts. The lactiferous ducts converge to the nipple forming an ampullar extension - the lactiferous sinus.
The stroma of the mammary gland is represented by dense fibrous and adipose tissue surrounding the gland and separating its lobes. There are three components of the stroma: subcutaneous, lying between the skin and the gland, intraparenchymal, located between the lobes and lobules, and retromammary, located behind the mammary gland. The mammary gland parenchyma is surrounded by a two-layer subcutaneous fascia, in which a superficial layer is isolated that actually covers the gland and contains fibrous septa called Cooper's ligaments, which form a supporting frame penetrating into the gland, and a deep layer that covers the posterior sections of the gland and separates the gland from the superficial fascia chest muscle. Cooper's ligaments - supporting ligaments divide the gland into lobes (Stavros, 2004).
The blood supply to the mammary gland is performed by the branches of the intercostal arteries, the perforating branches of the internal mammary artery, and also by the branches of the external mammary artery. The venous vessels run parallel to the arterial ones and merge into the axillary and subclavian vein and into the internal thoracic and superior vena cava.
The innervation of the mammary gland is carried out mainly due to the anterior cutaneous branches of 2-5 intercostal nerves and posterolateral branches of 3-5 intercostal nerves, as well as branches of the supraclavicular nerves.
The main route of lymph drainage from the breast is axillary way. Along with this path, the second path is important - the sternal, or "parasternal" path, where lymph is directed mainly from the deep sections of the mammary gland, mainly from its medial quadrants. In addition to these directions, lymph from the mammary gland can flow along additional ways: interpectoral, transpectoral, in the medial direction to the axillary lymph nodes of the opposite side, to the lymphatic network of the preperitoneal tissue of the epigastric region.
The mammary gland is a paired organ internal secretion. It is present in all species of the class of mammals, and its main function is to secrete milk and feed offspring.
All mammals have such glands, their number depends on the number of young, which this species can bear and feed.
This is interesting. In cetaceans, two mammary glands are located near the labia.
Before puberty, the structure of the mammary gland in girls and boys is the same. Around the age of 11-12 years, the milk ducts begin to gradually increase, and the gland becomes a little painful when pressed on it. This is completely normal and should not be worrying. At about 13-14 years of age, its growth accelerates significantly in girls and, with a normal hormonal background, completely stops in boys, remaining a rudimentary organ.
The rudiments of the mammary glands appear among the first - already at 5-6 weeks of development of the human embryo, you can see the tubercles, from which these glands will then develop. Surprising may be the fact that they were formed from the sweat glands.
In women, the full maturation of the mammary gland ends after breastfeeding the first child.
The organ consists of:
- adipose and connective tissue
- alveoli (glandular tissue)
- duct
By itself, the mammary gland is similar to a ball or hemisphere. Such a structure female gland retains heat best, especially during milk production. And with a spherical shape of the gland, there is no risk of strangulation of the baby during feeding.
The size of the gland and its development are not interconnected. Development depends on the amount of adipose and glandular tissue. The more glandular tissue there is, the more milk, and the more it can produce, the more developed it is. In fact, this means that even a small gland, consisting mainly of alveoli, will be more developed than a large one, which mainly contains fat.
The number of different tissues depends mainly on the lifestyle and nutrition of the woman herself, it can increase or decrease. Its main part is glandular tissue depends on hormonal levels. It often happens that a woman's breast size depends on menstrual cycle, and increases with the approach of critical days.
glandular tissue
It is attached to the muscles of the chest connective tissue, and between its lobes is adipose tissue.
It is divided into several parts, each woman in her own way - from 8 to 20. Their number may differ even on the right and left breasts of one woman. These lobes are located radially to the nipple. The lobes consist entirely of small lumps-bags in which milk is produced. All lobes are pierced by ducts that end at the nipple.
Normally, the structure of the mammary glands in boys and girls is the same before the onset of puberty. The organ is a modified form of the sweat glands.
Breast anatomy
Mammology is the study of the structure and function of the mammary glands. The main task of the female breast is the secretion of milk, and only then delivering aesthetic pleasure to the opposite sex. Breast growth and development in girls begins at puberty. Finally, the formation of the mammary glands ends by about 20 years. The breast of a sexually mature girl can have a variety of shapes and sizes, very often it is asymmetrical, which is also the norm. On the surface of the chest there is a protrusion - the nipple. There are several types of the latter:- flat;
- retracted;
- convex.
At the top of the nipple, milky pores open, which are a continuation of the ducts. The latter, in turn, originate from the milk lobules. 
chest body
The female breast itself is a convex rounded formation with a wide base adjacent to the tissues of the chest wall. The body of the female mammary gland consists of approximately 20 lobes with the apex facing the areola. The lobes are separated from each other by a connective tissue component. The rest of the space is occupied adipose tissue, on the amount of which the shape and size depend. The glands are fed by the internal and lateral thoracic arteries.
When breastfeeding, size and shape do not matter, because milk production is carried out due to the glandular component (lobes, lobules and alveoli), while fat does not play any role.
During pregnancy and lactation, breast weight increases to 300-900 g. In the first time after childbirth, iron produces primary milk - colostrum. It is rich nutrients, macro- and microelements. Subsequently, transitional milk is produced and mature milk appears by the end of the first week. There is a formation of lactation, and the breast can fully fulfill its natural purpose. After graduation breastfeeding the mammary glands are reduced and the breasts in some women may return to their previous size.
Anomalies in the development of glands include:
- amastia - complete atrophy and underdevelopment of the mammary glands (one- and two-sided are distinguished);
- polythelia - polynipple, probably comes from ancestors from the animal world;
- macromastia - giant glands weighing up to 30 kg;
- polymastia - the presence of additional glands, most often they are found in the armpits.
The male gland has an identical structure, but normally does not develop. The nipple and areola are very small, the lobules of the ducts are not developed, so milk production in them is impossible. The body of the gland has dimensions of the order of 1-2 cm in width and 0.5 cm in thickness. There are cases when, in case of violation hormonal background in men, breast enlargement occurs, this condition is called "true gynecomastia." Consultation with a specialist is required to find the cause hormonal imbalance. The false form occurs with severe obesity, and to solve this problem, normalization of body weight is required.
Plastic surgery methods
Currently, modern plastic surgery is able to satisfy the wishes of even the most demanding patients and correct a huge number of breast defects.Mammoplasty - surgical intervention from the area plastic surgery aimed at changing the shape and size of the breast, eliminating prolapse. Such an operation is resorted to in the rehabilitation of patients who have undergone treatment for oncological pathology.
- gland reduction;
- lift;
- liposuction;
- breast endoprosthesis.
Breast augmentation is performed according to aesthetic indications using implants. Reduction (reduction and liposuction) is an operation that is performed with gigantism of the mammary glands. The main indication is heavy, drooping glands. This situation causes physical and emotional discomfort. Very often, surgery is resorted to due to heavy load on the spine and shoulder girdle.
Breast lift is necessary for women with ptosis problem. Breast prolapse can occur at any age. There are several stages depending on the degree of downward deviation of the nipple. From the same area, the distance to the jugular notch is calculated.
Causes of the phenomenon:
- age-related skin changes;
- loss of tone and elasticity due to stretching of the skin (pregnancy, weight gain, and after fast weight loss);
- heredity;
- bad habits.
In conclusion, it should be noted that one of the most burning and urgent problems in medicine is breast cancer. Among malignant neoplasms in women, oncology of this localization is in the first place. It is imperative to undergo examinations by a mammologist and independently examine your breasts for the presence of seals and nodules.
The mammary glands in women are located at the level of 3-6 pairs of ribs and are fixed on the anterior dentate pectoral muscle, while the gland itself has no muscles. The nipple is located just below the middle of the breast and is surrounded by an areola. Its color and size are individual, but usually in nulliparous girls and women it is pinkish or dark red, in women who have given birth it becomes darker and acquires a brownish color. The surface of the nipple is wrinkled, its most convex point has milky pores through which milk enters.
Fact: exercises for the anterior pectoral muscles in no way affect the shape of the chest and its tightness.
Inside the gland has up to twenty lobes, which are filled with milk during lactation, the rest of the space is filled with glandular tissue. Each major share is made up of several smaller shares. The tops of the large lobes are directed towards the nipple and are connected with it by the lactiferous ducts, which pass into the milky pores. At the same time, there are much fewer milky pores than ducts: many small ducts on the way to the gland are connected into several large ones. Each duct expands as it approaches the nipple, then narrows again as it approaches the pores, creating a reservoir for storing the produced milk.
Size
The shape and size of the breasts depend on the age of the woman, her individual characteristics and the number of births. Right and left gland may vary slightly in shape and size, but, as a rule, right gland A bit more.
Minor changes in the shape of the glands occur during the course of the menstrual cycle: immediately before menstruation, swelling appears, the number of glandular passages increases, after menstruation everything returns to normal. The reason for the swelling of the mammary glands in this case is the action of hormones that change depending on the menstrual phase.
Fact: breast size does not affect the amount of milk produced during lactation.
The thickness of the fat layer located on its back wall significantly affects the size of the breast. More plump women possess big size chest, while in slender women its volume will be much smaller.
However, with a small amount excess weight the breast can be quite large - this is due to the large volume of glandular tissue. In such cases, with an improperly selected bra, diaper rash often appears under the mammary glands, the treatment of which includes the choice of more comfortable clothing, careful hygiene and the use of drying ointments. Provoke the appearance of diaper rash can and skin diseases, a general decrease in immunity or allergies.
Development and functions
The main function of the mammary gland is the production and secretion of milk. Pituitary and ovarian hormones have a stimulating effect on the lactation process, which is why if their level is disturbed, hypogalactia may develop - a condition characterized by the absence or insufficient production of milk.
The glands begin to develop at the very beginning adolescence by activating gonadotropic hormones. The action of these hormones is aimed at the maturation of the ovarian follicles, which, in turn, begin to produce estrogens - female hormones. It is they who influence the development of the genital organs and the appearance of secondary sexual characteristics - the formation of the breast, buttocks and female figure generally.
Fact: after the onset of menopause, a decrease in estrogen levels contributes to the replacement of glandular tissue in the mammary gland with fatty tissue.
During pregnancy, the formed placenta begins the secretion of its own hormones, reducing the production of pituitary hormones. During this period, there is an increase in the glandular lobes, and closer to childbirth, milk production begins. Delivery and delivery of the placenta stimulate the onset of lactation. Oxytocin and prolactin have the most significant influence at this time - their interaction awakens the maternal instinct and promotes milk production.
Causes of diseases
Breast diseases are different, but have similar risk factors in which their development is most likely. The most common symptom is pain in the mammary glands.
Main reasons:
- genetic predisposition;
- hormonal imbalance, insufficient or excessive production of sex hormones;
- disease thyroid gland- the insufficiency of its functions increases the risk of mastopathy;
- diseases of the liver, gallbladder and / or bile ducts;
- overweight;
- lack of iodine;
- prolonged stress, neurosis, depression, chronic fatigue;
- lack of regular sexual life;
- bad habits - smoking, alcohol;
- breast injury;
- abortions - after they are carried out, the tissue of the glands undergoes regression, which can occur unevenly and contribute to the development of tumors;
- late pregnancy;
- lack of breastfeeding after childbirth;
- early start menstrual cycle and later termination.
Fact: early childbirth, as well as birth and breast-feeding two or more children by a woman under 25 years of age significantly reduce the risk of developing breast diseases.
Symptoms
The most common disease symptoms mammary glands:
- discharge from the mammary glands in the absence of pregnancy and lactation;
- pain in the mammary gland and its sensitivity, regardless of the phase of the cycle; if these symptoms are noted only before menstruation or during feeding, then this can be considered the norm;
- detection of seals during palpation of the gland;
- deformation of the mammary glands;
- change skin in the chest area: the appearance of redness, rash, etc.;
- a change in the shape of one of the glands, rarely both, is manifested by a well-marked asymmetry;
- change in the shape or color of the areola of the nipple, the appearance of rashes;
- increase lymph nodes in the armpits.
Important: a mammologist is engaged in the diagnosis of such diseases, therefore, if similar symptoms you need to contact him.
Developmental pathologies
There are two groups of possible pathologies:
- true, arising in connection with the presence of a hereditary predisposition or caused by a violation of intrauterine development;
- defects resulting from a violation of hormonal or other functions of the body, incl. caused by trauma, exposure, etc.
Quantitative anomalies:
- monomastia - complete absence one of the glands, congenital defect. It develops at the sixth week of pregnancy, at the very beginning of the laying of the glands;
- polymastia - the development of more than two mammary glands, which can be located in almost any part of the body. As a rule, such glands are underdeveloped and cannot function normally;
- polythelia - the formation of an additional number of nipples.
Fact: most anomalies are determined immediately after birth, when viewed in the hospital. Most often, they are corrected surgically.
Structural anomalies:
- ectopia - displacement of the location of the mammary gland;
- micromastia - the small size of the mammary glands is inconsistent with age and physique;
- hypoplasia - underdevelopment of glands and nipples;
- macromastia - hypertrophy, characterized by a large volume of the mammary glands.
Often there are congenital anomalies in the shape of the breast. These include the tubular form of the mammary glands - this pathology characterized by an elongated shape of the chest with a lack of glandular tissues. Such pathologies are not a disease and are considered an aesthetic defect.
Mastopathy
Mastopathy is a benign disease resulting from the growth of connective tissues in the mammary gland. There are two forms of mastopathy - diffuse and nodular. In the first case, the glandular tissue grows evenly, and in the second, it forms nodes.
Causes
The main reason for the development of mastopathy is hormonal imbalance:
- early onset of menstruation;
- late first pregnancy;
- lack of breastfeeding;
- long-term delay in menopause (after 50 years);
- inflammation of the genital organs;
- problems with the menstrual cycle;
- prolonged stress;
- abortions.
Fact: most of all, the development of mastopathy is affected by a violation of the secretion of hormones such as estrogens and progesterone. Concomitant diseases often endometriosis, uterine fibroids and ovarian cysts.
Symptoms
The main symptoms of mastopathy:
- transparent discharge from the mammary glands when pressed;
- deterioration of the skin in the chest area;
- the presence of seals on palpation;
- pain in the area of the mammary gland and its hypersensitivity;
- pronounced premenstrual syndrome;
- change in the shape of the gland.
Discharge from the mammary glands when pressed can be green, brownish or yellowish - this indicates fluid stagnation as a result of blockage or a decrease in the lumen of the channel due to seals formed.
Diagnostics
Often, mastopathy can be determined using self-examination. This procedure must be performed first standing, then lying down. It is best to examine the breasts after menstruation. The procedure includes examining the breast with arms raised and lowered, and palpation of the breast. If seals are found, it is necessary to consult a doctor who will additionally conduct an ultrasound.
Important! If a seal (infiltration in the mammary gland) is detected, the formation of which is accompanied by an increase in temperature and general weakness mastitis can be diagnosed - inflammatory disease chest.
Treatment
The patient is assigned complex therapy, aimed at normalizing the hormonal background, treating inflammation of the genital organs and other diseases that cause mastopathy. The prescribed therapy depends on the age of the woman.
With inefficiency drug treatment often assigned surgical intervention, especially often this is used for the nodular form of mastopathy. IN severe cases it is necessary to completely remove the affected mammary glands.
Conclusion
Breast health is important for every woman. If you experience any symptoms of her illness, you should immediately consult a doctor. In addition, it is necessary to regularly monitor the health of the whole organism, otherwise many neglected diseases can lead to a violation reproductive function or ability to lactate.
The mammary gland is a paired organ surrounded by adipose tissue, which determines its shape. In addition, due to age, functional state (pregnancy, feeding), its size and shape change significantly.
A depression is formed between the right and left breasts.
In the middle parts of the chest is the areola, in the center of which is nipple. Both the areola and the nipple are pigmented.
The composition of the mammary gland includes the body, adipose and fibrous tissue.
The body of the mammary gland consists of 15 - 20 separate lobes surrounded by adipose tissue.
Each lobe has an excretory lactiferous duct, which goes to the nipple and, before entering the nipple, forms a fusiform extension - the lactiferous sinus. The end narrowed part of the duct pierces the nipple and opens at its apex with a funnel-shaped enlarged lactiferous opening. Pure lactiferous openings less than number shares (from 8 to 15). as some of the ducts merge with one another.
Each lobe of the mammary gland and the body of the breast as a whole is surrounded by adipose tissue, the presence of which gives the breast a hemispherical shape. Connective tissue processes are directed from the anterior surface of the gland to the skin. The posterior surface of the mammary gland is smooth and separated by a capsule leaf from the underlying fascia of the pectoralis major muscle. Through the capsule (part of the superficial fascia), the mammary gland is fixed to the collarbone.
The mammary gland is enclosed in a connective tissue capsule, which sends partitions between the lobes into the thickness of the gland.
On the areola of the mammary gland there are tubercles located under the skin - rudimentary mammary glands (glands of the areola), which open outward through ducts.
In the region of the areola, there are small purely sweat and large sebaceous glands.
According to the histological structure of the mammary gland - complex alveolar-tubular.
The main function is the secretion of milk.
Some features of the lactating mammary gland:
1. Secretory departments.
Under the influence of progesterone in combination with estrogens, prolactin and somatotropin, the differentiation of the secretory sections of the gland begins. Already at the 3rd month of pregnancy, the first alveoli appear.
Under the influence of prolactin in the membrane of alveolar cells, the density of receptors for both prolactin and estrogen increases. However, the lactogenic effect of prolactin is suppressed high concentrations estrogen and progesterone.
A high level of estrogen inhibits the binding of prolactin to its receptors in the alveolar cell membrane.
2. Colostrum.
In the first 2-3 days after childbirth, the mammary gland produces colostrum. Unlike milk, colostrum contains more protein, but less carbohydrates and fats. In addition, cellular fragments are found in colostrum, as well as whole cells that have phagocytized fat. - colostrum bodies.
3. Milk.
After the birth of a child, the concentration of estrogen and progesterone in the mother's blood decreases sharply. This allows prolactin to initiate milk secretion by the alveolar cells. During lactation, alveolar cells secrete fats, casein, alpha-lactoalbumin, lactoferrin. serum albumin, lysozyme. lactose. The composition of milk also includes water, salts, antibodies. Immunoglobulins A, using specific receptors in the membrane of alveolar cells, penetrate into the cytoplasm of the latter, are transported to the apical surface, and then released into the lumen of the secretory part of the gland. Maternal antibodies provide humoral immunity to the newborn.
4. Feeding.
During feeding of the child, irritation of the nerve endings of the nipple of the mammary gland is transmitted through afferent pathways into the hypothalamus. Afferent impulses stimulate the secretion of oxytocin in the supraoptic and paraventricular nuclei.
Oxytocin causes contraction of myoepithelial cells and thereby promotes the movement of milk into the excretory ducts. In breastfeeding mothers, spontaneous secretion of oxytocin also occurs while playing with the baby or when he cries.
Lactation is supported by prolactin. The secretion of prolactin occurs during breastfeeding. Within 30 minutes, the content of prolactin in the blood increases sharply, which stimulates the secretory activity of alveolar cells and contributes to the accumulation of milk for the next feeding. Lactation can last as long as the baby will suckle the breast (cause irritation of the nerve endings of the nipple of the breast).
Loading...