The upper and outer quadrant of breast is a frequent site of carcinoma (cancer). Several anatomical facts are of importance in diagnosis and treatment of this condition. Abscesses may also form in the breast and may require drainage. The following facts are worthyof note.
Incisions of breast are usually made radially toavoid cutting the lactiferous ducts.
1. Cancer cells may infiltrate the suspensory ligaments. The breast then becomes fixed.Contraction of the ligaments can cause retractionor puckering (folding) of the skin.
2. Infiltration of lactiferous ducts and their consequent fibrosis can cause retraction of the nipple.
3. Obstruction of superficial lymph vessels by cancer cells may produce oedema of the skin giving rise to an appearance like that of the skin of an orange(peau d'orange appearance).
4. Because of communications of the superficial lymphatics of 'the breast across the midline, cancer may spread from one breast to the other.
5. Because of communications of the lymph vessels with those in the abdomen, cancer of the breast may spread to the liver, and cancer cells may 'drop' into the pelvis producing secondaries there.
6. Apart from the lymphatics, cancer may spread through the segmental veins. In this connection, it is important to know that the veins draining the breast communicate with the vertebral venous plexus of veins. Through these communicationscancer can spread to the vertebrae and to the brain.
Preventive and diagnostic measures
Self examination of breast as follows;
a. Inspect: Symmetry of breasts and nipples.
b. Change in colour of skin.
c. Retraction of nipple is a sign of cancer.
d. Discharge from nipple on squeezing it.
e. Palpate all four quadrants with palm of hand.Note any palpable lump.
f. Raise the arm to feel lymph nodes in axilla.
g. Mammogram may reveal cancerous mass.
h. Fine needle aspiration cytology is safe and quick method of diagnosis of lesion of breast.
Note worthy;
Retracted nipple is a sign of tumour in the breast.
Cancer of the mammary glands is the most comnon cancer in females of all ages. It is more frequently seen in postmenopausal females due to lack of oestrogen hormones.Self-examination of the mammary gland is the only way for early diagnosis and appropriate treatment.
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