Congenital and developmental abnormalities of the breast and their clinical implications

The human breast is an epidermal appendage derived from apocrine glands. The adult breast base overlies the second to sixth ribs in the midclavicular line and lies anterior to the deep pectoral fascia, overlying the pectoralis major muscle and the serratus anterior muscle inferolaterally. It is enclosed in a split of the superficial fascia and comprises a variable proportion of glandular tissue, fat and connective tissue, the relative proportions of which change throughout adult life. Some structural support is provided by the fibrous suspensory ligaments of Astley Cooper, also known as Cooper’s ligaments, which run from the deep dermis to the deep fascia. The adult breast consists of 15-20 lobes, each with a major duct opening into the nipple papilla. Within each lobe, the major ducts divide into progressively smaller extralobular ducts, terminating in numerous terminal duct lobular units, the functional unit of the breast, each with an intralobular duct connecting to up to 30 acini. Development of the breast is complex and commences early in utero.

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