THE BREAST ANATOMY

The Breast Anatomy

The female breasts


The female breasts, also known as the mammary glands, are accessory orgns of reproduction.



Situation One breast is situated on each side of the sternumand extends between the levels of the second and sixth rib. The breasts lie in the superficial fascia of the chest wall over the pectoralis major muscle, and are stabilized by suspensory ligaments.



Shape Each breast is a hemispherical swelling and has a tailof tissue extending towards the axilla (the axillary tail of spence).



Size The size varies with each individual and with the stage ofdevelopment as well as with age. It is not uncommon for one breast to be little or larger than the other.



Gross structure


The axillary tail is the breast tissue extending towards theaxilla.



The areoa is a circular area of loose, pigmented skin about2.5 cm in diameter the centre of each breast. It is a pale pink colour in a fair- skinned woman, darker in a brunett, the colour deepening with pregnancy. Within the area of the areola lie approximately 20 sebaceous glands. In pregnancy these enlarge and are known as montgeomery’s tubercles.



The nipple lies in the centre of the areola at the level of thefourth rib. Aprotuberance about 6mm in length, composed of pigmented erectile tissue.The surface of the nipple is perforarted by small orifices which are the openings of the lactiferous ducts. It is covered with epithelium.



Microscopic structure The breast is composed largely ofglandular tissue, but also of some fatty tissue, and is covered with skin. This glandular tissue is divided into about 18 lobes which are completely separated by bands of fibrous tissue. The internal structure is said to be resemble as the segments of a halved grape fruit or orgnge. Each lobe is a self-contained working unit and is composed of the following structures



Alveoli: Containing the milk- secreting cells. Each alveolus islined by millk-secreting cells, the acini, which extract from the mammary blood supply the factors essential for milk formation. Around each alveolus lie myoepithelial cells, sometimes called ‘basket’ or ‘spider’s cells. When these cells are stimulated by oxytocin they contract releasing milk into the lactifierous duct.



Lactifierous tubules:small ducts which connect the alveoli.



Lactifierous duct:a central duct into which the tubules run.



Amplulla:the widened-out portion of the duct where milk isstored. The ampullae lie under the areola.



Blood supply Blood is supplied to the breast by the internalmammary, the external mammary and the upper intercostals arteries.Venous drainage is through corresponding vessles into the internal mammary and axillary veins.





Lymphatic drainage This is largely into the axillary glands, with some dranage in to the portal fissure of the liver and mediastinal glands. The lymphatic vessels of each breast communicate with one another.



Nerve supply The function of the breast is largely controlledby hormone activity but the skin is supplied by breanches of the thoracic nerves. There is also some sympathetic nerve supply, especially around the areola and nipple.

ORPHAN DRUGS AND TREATMENT OF RARE DISEASES

Orphan Drugs & Treatment of Rare Diseases

Drugs for rare diseases-so-called orphan drugs-can be difficult to research, develop, and market. Proof of drug safety and efficacy in small populations must be established, but doing so is a complex process. Furthermore, because basic research in the pathophysiology and mechanisms of rare diseases receives relatively little attention or funding in both academic and industrial settings, recognized rational targets for drug action may be few. In addition, the cost of developing a drug can greatly influence priorities when the target population is relatively small. Funding for development of drugs for rare diseases or ignored diseases that do not receive priority attention from the traditional industry has received increasing sup-port via philanthropy or similar funding from not-for-profit foundations such as the Cystic Fibrosis Foundation, the Huntington’s Disease Society of America, and the Gates Foundation.

The Orphan Drug Amendments of 1983 provides incentives for the development of drugs for treatment of a rare disease or condition defined as “any disease or condition which (a) affects less than 200,000 persons in the U.S. or (b) affects more than 200,000 persons in the U.S. but for which there is no reasonable expectation that the cost of developing and making available in the U.S. a drug for such disease or condition will be recovered from sales in the U.S. of such drug.” Since 1983, the FDA has approved for marketing more than 300 orphan drugs to treat more than 82 rare diseases.