Anatomy of the breast

 

The breast: the essence of womanhood

The female breast is the essence of womanhood. Its external appearance is an individual feature. The genes primarily determine if a patient has small or large, or soft or firm breasts. The shape of the female breast changes with advancing age as well as with the menstrual cycle. The hormone level rises during the menstrual period. This makes the breast swell for a couple of days because the body is preparing for a possible pregnancy and breast-feeding. This increases the circulation and fluid collection in the breast tissue. The breast skin is tenser and the breasts look large due to the accumulated fluid.

In medicine, the breast is called the ‘mammary gland’. It largely consists of fatty and connective tissue. Embedded in fatty and connective tissue is the glandular tissue that produces milk. This tissue consists of grape-like, 15-cm-long glands known as lobules. These are connected to the nipple by milk ducts. At the end of the milk ducts are milk sacs that act as a pump during breast feeding.

The breast also has nerves, arteries and lymph vessels. The nerves keep the body in motion. Without them we couldn’t think or execute any intended movements. The lymph vessels can be compared with the blood vessels. They do not however transport blood, but are in charge of the drainage of lymph from the tissues. The lymph vessels run like pipelines through the body and have lymph nodes along them.  These are soft and non-palpable filter stations where the lymph is filtered: pathogenic agents, waste products and foodstuffs flow through them and are thus registered by the body. Lymph vessels in the breast can spread breast cancer cells to the rest of the body.

Another element of the breast is the nipple, surrounded by the areola. Sebaceous glands called Montgomery glands are located in the areola surrounding the nipple.

The female breast develops at puberty, at an average age of 11. The breast is in most cases fully formed after the age of 16.

The breast tissue changes markedly with advancing age, especially after pregnancies and with menopause. The ratio of fatty tissue and connective and glandular tissue is no longer the same. At young age it is 1:2, but at higher ages the amount of fatty tissue is much higher. The colour of the nipple and areola also change with age too, in most cases turning darker.  

Malformations of the female breast

There are various types of breast malformations. They occur alone or in combinations. The aspect of the breast varies from woman to woman. The most common anomalies of the female breast are the following:

  • Breast aplasia denotes a lack of breast growth. Fatty tissue, as well as breast gland and the pectoral muscle, are absent. This type of breast malformation can be corrected by means of breast implants.
  • Breast hypoplasia is something similar. An abnormality in the development of the breast tissue leads to a breast of reduced size. Affected women suffer because of the small breast. Only breast augmentation can help.
  • The breast hyperplasia is the opposite of the aplasia: it is an increased accumulation of breast tissue and thus a very large breast. This could lead to physical issues, such as back pain. The so-called ‘gigantic breast’ is known in medicine as gigantomastia. That denotes a breast weighing more than 1.5 kg. It can be corrected by means of breast reduction. The excessive growth of the breast is caused by hormonal factors such as pregnancy or the onset of puberty.
  • The malformation of the chest is called funnel chest. The cartilage parts of the ribs grow abnormally, producing a caved-in appearance of the chest. This can develop because of vitamin D deficiency or genetic factors. Severity can vary; the depth of the funnel varies from woman to woman. The funnel chest can only be corrected through surgery with chest reconstruction.
  • The tubular breast is a malformation in which the base of the breast is very narrow. It can be mild or severe. The ratio between breast and nipple is very unbalanced; this bothers affected women. In many cases the lower part of the breast is not developed and the nipple hangs downwards.
  • The malformation called pigeon chest is caused by the protrusion of the sternum. This leads to a breast of abnormal shape.
  • Poland syndrome is a malformation that has received little attention. It develops in the ninth week of pregnancy because of a deficient anlage of the chest muscle. It consists of the absence of the breast and pectoral muscle on one side.
  • The so-called Amazone syndrome is an asymmetry of the breast, which is markedly deformed on one side. The difference from Poland syndrome is that with Amazone syndrome, only the breast is absent.