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Breast Anatomy & Physiology — MRCS Revision

🩷 Breast Anatomy & Physiology

Structure, boundaries, vasculature, lymphatics, nerve supply, Cooper’s ligaments, hormonal physiology — MRCS high-yield.

Overview & Boundaries

What Is the Breast?

The breast is a modified apocrine sweat gland that lies within the subcutaneous fat of the anterior chest wall, situated between the superficial and deep layers of the superficial fascia. It has no true capsule — the gland merges imperceptibly with the surrounding subcutaneous fat, which has important implications for surgical resection margins in breast cancer.

The breast overlies the pectoralis major (and partly serratus anterior and external oblique) and rests on the deep pectoral fascia. A layer of loose areolar tissue — the retromammary space (of Chassaignac) — separates the posterior breast from the deep fascia, allowing the breast to move freely on the chest wall.

Boundaries of the Breast
Superior
2nd rib (or clavicle) — the breast extends superiorly to approximately the level of the 2nd rib, with the clavicle forming the upper boundary of the breast region
Inferior
6th rib (inframammary fold) — the inframammary fold is a well-defined skin crease marking the inferior boundary; an important surgical landmark for implant placement and breast reconstruction
Medial
Lateral border of the sternum (sternal edge) — medial breast overlies the sternocostal junctions; this quadrant drains to the internal mammary / parasternal nodes
Lateral
Anterior border of latissimus dorsi / mid-axillary line — the axillary tail (tail of Spence) extends beyond this boundary, piercing the deep fascia (clavipectoral fascia) to enter the axilla
FeatureDetail
Vertical extentRibs 2–6 (some texts quote clavicle as upper boundary — both acceptable)
Deep surfaceRests on pectoralis major fascia (and serratus anterior + external oblique laterally)
Retromammary spaceLoose areolar plane between posterior breast and deep pectoral fascia — allows breast mobility; plane used in subpectoral implant placement
Axillary tail (Tail of Spence)Lateral prolongation of the upper outer quadrant — extends through the clavipectoral fascia into the axilla; can be palpated; may harbour breast tissue (and cancer) within the axilla
No capsuleCritical for surgery — no anatomical plane demarcates gland from surrounding fat; margins must be assessed histologically

Breast Anatomy Diagram

Breast anatomy diagram showing boundaries, lobes, ducts, Cooper's ligaments, and key structures
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