ANATOMY OF THE BREAST AND AXILLA

DR FAITH A BOB
MMED PAEDIATRIC SURGERY
MODERATOR –DR ODULA
INTRODUCTION

AXILLA
 Space between upper arm and side of the
thorax.
 Bounded by anterior and posterior axillary
folds and continuous with the posterior
triangle of the neck
 Contains neurovascular structures and lymph
nodes.
Introduction
contents

 Axillary sheath (axillary a. & brachial plexus)

 Axillary vein & lymphatics (outside sheath)
 Fat & connective tissue
 Cutaneous nerves
Axillary artery
Axillary artery
Brachial plexus
Lymph nodes

 Contained in the fibro fatty tissue of the axilla

 Varies between 20 and 30 in number
 Grouped into 5 groups
a)anterior /pectoral group-upper half of trunk and major part of breast
b)posterior/subscapular group-upper half trunk posteriorly, axillary tail of
breast
c)Lateral group-upper limb
d)central group-receiving from the upper group
e)apical group-from the above groups->subclavian
lymph group>thoracic duct/right lymphatic duct or jugulosubclavian
junction. A few to the supraclavivular (deep cervical nodes)
Axillary lymph nodes
Breast

 Also referred to as mammary gland

 Modified sweat gland
 Developed as early as week four from the mammary
ridge of the ectoderm extending from the axilla to the
inguinal region
 Major part of the mammary ridge disappears ,thoracic
region persists and penetrates the underlying
mesenchyme
 Forms sprouts/buds->lactiferous ducts and alveoli
respectively
Breast

 Lactiferous ducts drain into an epithelial pit which transforms into

nipple.
 Accessory nipples or glands can be found along their line of
migration
 Contains glandular and fatty tissue
 It overlies the superficial fascia extending from fascia of scarpa and
forms a capsule posterior to the breast
 Between the capsule and the fascia of pectoralis major is the retro
mammary space; allows free movement of the breast
 Attached to the overlying dermis by suspensory ligament –
COOPER’S Ligament*
ORGANIZATION OF THE BREAST
Blood supply

 Enter from superior/medial & superior /lateral aspects

 Penetrate deep surface of breast
 Exhibit extensive branches & anastomoses

 Lateral thoracic artery

 Internal thoracic artery
 Intercostal artery
 Thoracoacromial artery
Blood supply
Lymphatic drainage
Congenital malformations

 Polythelia is a condition where accessory nipples have

formed due to the persistence of fragments of the
mammary line. Accessory nipples may develop
anywhere along the original mammary line, but usually
appear in the axillary region.
 Polymastia occurs when a remnant of the mammary
line develops into a complete breast.
 Inverted nipple is a condition in which the lactiferous
ducts open into the original epithelial pit that has failed
to exert.
Congenital malformations

 Amastia ????
 Amazia???