1;Preface;5 2;Acknowledgements;6 3;Table of Contents ;7 4;Contributors;10 5;1. Anatomy and Physiology of the Breast ;15 5.1;List of Abbreviations;15 5.2;1.1 Gross Anatomy of the Breast;16 5.2.1;1.1.1 Relationships and Quadrants;16 5.2.2;1.1.2 Nerve Supply;16 5.2.3;1.1.3 Vascular Supply;18 5.2.4;1.1.4 Lymphatic Drainage;18 5.2.5;1.1.5 Gross Anatomical Changes Throughout the Lifespan;20 5.3;1.2 Histology;20 5.3.1;1.2.1 Overview;20 5.3.2;1.2.2 Nipple and Areola;21 5.3.3;1.2.3 Parenchyma;22 5.3.3.1;1.2.3.1 Luminal Epithelial Cells;22 5.3.3.2;1.2.3.2 Myoepithelial Cells;22 5.3.3.3;1.2.3.3 Stem Cells;22 5.3.4;1.2.4 Basement Membrane;24 5.3.5;1.2.5 Stroma;24 5.3.5.1;1.2.5.1 Cells in Breast Stroma;25 5.3.5.2;1.2.5.2 Extracellular Matrix;26 5.4;1.3 Synopsis of Hormones and Other Factors that Regulate Breast Structure and Function;26 5.4.1;1.3.1 Hormones;26 5.4.2;1.3.2 Other Regulators of Breast Development;28 5.5;1.4 Mammary Gland Structure and Function Throughout Life;29 5.5.1;1.4.1 Prenatal Development of the Breast;29 5.5.1.1;1.4.1.1 Events of Prenatal Breast Development;29 5.5.1.2;1.4.1.2 Hormonal Regulation of Prenatal Breast Development;30 5.5.1.3;1.4.1.3 Genes, Transcription Factorsand Growth Factors During Prenatal Breast Development;30 5.5.2;1.4.2 Breast Development from Birth to Puberty;31 5.5.2.1;1.4.2.1 Events in Breast Development from Birth to Puberty;31 5.5.2.2;1.4.2.2 Hormones in Breast Development from Birth to Puberty;31 5.5.2.3;1.4.2.3 Other Regulatory Factors in Breast Development from Birth to Puberty;31 5.5.3;1.4.3 Puberty;31 5.5.3.1;1.4.3.1 Events in the Breast During Puberty;31 5.5.3.2;1.4.3.2 Hormonal Regulation of the Breast During Puberty;32 5.5.3.3;1.4.3.3 Other Regulatory Factors in Breast Development During Puberty;33 5.5.4;1.4.4 The Adult Premenopausal Breast;33 5.5.4.1;1.4.4.1 Cyclic Events in the Premenopausal Adult Breast;33 5.5.4.2;1.4.4.2 Hormones Regulating the Adult Premenopausal Breast;34 5.5.4.3;1.4.4.3 Stat5 in the Adult Premenopausal Breast;34 5.5.5;1.4.5 Pregnancy;34 5.5.5.1;1.4.5.1 Events in the Breast During Pregnancy;34 5.5.5.2;1.4.5.2 Hormones in the Breast During Pregnancy (Fig. 1.15);35 5.5.5.3;1.4.5.3 Other Regulatory Factors in Breast Development during Pregnancy;36 5.5.6;1.4.6 Lactation;36 5.5.6.1;1.4.6.1 Events in the Lactating Breast;36 5.5.6.2;1.4.6.2 The Process of Lactation;37 5.5.6.3;1.4.6.3 Hormones During Lactation and Nursing;38 5.5.6.4;1.4.6.4 Other Regulatory Factors During Lactation;38 5.5.6.5;1.4.6.5 Effects of Lactation on the Nursing Mother;39 5.5.6.6;1.4.6.6 Calcium Metabolism During Lactation;39 5.5.7;1.4.7 Postlactational Involution;39 5.5.8;1.4.8 Postmenopausal Involution;40 5.5.9;1.4.9 Concluding Comments;40 5.6;1.5 Appendix;41 5.6.1;1.5.1 A Brief Comparison of Murine and Human Breast;41 5.7;References;42 6;2. Congenital and Developmental Abnormalities of the Breast ;51 6.1;2.1 Anatomy of the Breast;53 6.2;2.2 Premature Thelarche;53 6.3;2.3 Breast Masses;53 6.3.1;2.3.1 Gynecomastia;55 6.3.2;2.3.2 Accessory Breast Tissue:Polymastia/Polythelia;56 6.4;2.4 Congenital Breast Hypoplasia/Aplasia;57 6.4.1;2.4.1 Poland Syndrome;57 6.4.2;2.4.2 Tubular/Tuberous Breast;58 6.4.3;2.4.3 Idiopathic Asymmetry;59 6.4.4;2.4.4 Amastia/Athelia;59 6.5;2.5 Inverted Nipples;60 6.6;2.6 Gigantomastia;60 6.6.1;2.6.1 Juvenile Hypertrophy;60 6.6.2;2.6.2 Gravid-Induced Gigantomastia;61 6.6.3;2.6.3 Drug-Induced Gigantomastia;61 6.7;2.7 Deformational Breast Abnormalities: Iatrogenic,Traumatic;61 6.8;2.8 Conclusion;62 6.9;References;63 7;3. Nipple Discharge ;66 7.1;3.1 Introduction;66 7.2;3.2 Anatomy and Physiology;66 7.3;3.3 Definition;66 7.4;3.4 Incidence;67 7.5;3.5 Characteristics and Etiology;68 7.6;3.6 Diagnostic Evaluation;72 7.7;3.7 Mammography;72 7.8;3.8 Ultrasound;73 7.9;3.9 MRI;73 7.10;3.10 Occult Blood;73 7.11;3.11 Cytology;74 7.12;3.12 Biochemical Markers;74 7.13;3.13 Ductal Imaging;75 7.14;3.14 Surgical Evaluation and Treatment;75 7.15;3.15 Mammary Ductoscopy;76 7.16;3.16 Follow Up;