Which of the following statement(s) is/are true concerning the anatomy of the breast?

b. Nerves within the axillary fat pad include the intercostal brachial nerve, the long thoracic nerve, and thoracodorsal nerve

c. Fascial bands projecting through the breast to the skin form a supporting framework known as Cooper’s ligaments

The breast abuts against the fascia of the pectoralis major and serratus anterior muscles. Projections of the fascia course through the breast to the skin, forming a supporting framework of the breast parenchyma. These fascial bands, called suspensory ligaments of Cooper, are better developed in the upper breast. The structure of the breast can be divided into lobular and ductal elements. The lobule is the functional unit of the breast. Within a lobule, the terminal elongated tubular ducts are referred to as alveoli. Ten to one hundred alveoli coalesce to form a larger duct which defines a lobular unit. The lobular ducts join to form progressively larger ducts and ultimately an excretory duct. The alveolar ducts, lobular ducts, and excretory ducts are all lined with either cuboidal or columnar epithelium. Eventually, 10-20 excretory ducts, each dilate into a short excretory sinus (lined with squamous epithelium) just beneath the areola. Excretory ducts then course perpendicular to exit through the nipple.

The lymphatic anatomy of the breast is of interest to the surgeon because of the tendency of breast cancer to involve the regional lymph nodes. Studies using radioactive tracers demonstrate at least 97% of lymphatic flow from the breast is into the axilla; the remainder courses into the internal mammary nodes. These studies also show that lymph flowing into the internal mammary gland chain is not restricted in origin to the medial half and sub-areolar region of the breast, as was thought, but can originate in any quadrant of the breast. In the axilla, lymphatic vessels terminate in the lymph nodes embedded within the axillary fat pad. Also within the axillary fat pad are the intercostal brachial nerves (a sensory nerve supply in the under arm), the long thoracic nerve (a motor nerve to the serratus anterior and subscapularis muscles) and the thoracodorsal nerve (a motor nerve to the latissimus dorsi adjacent to its accompanying arteries and veins).