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Breast Cancer Module I: Breast Anatomy, Physiology, and Pathology

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Target Audience and Goal Statement

This activity is intended for primary care providers who perform screening and clinical breast exams.

The goal of this activity is to enable primary care providers to better understand the anatomy, physiology, and pathology of the breast.

Upon completion of this activity, participants will be able to:

  • Identify the normal anatomy and physiology of the breast
  • Distinguish abnormal clinical and pathology findings of the breast
  • Define the major types of benign and malignant breast lesions and their prognostic significance

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Breast Cancer Module I: Breast Anatomy, Physiology, and Pathology


Nipple and Areola

The nipple and areola are separate structures. The unique anatomy explains why 18% of malignant cancers are found in the subareolar region, a location not easily palpated unless using a technique that permits palpation to the chest wall (Figure 3) (see Module II).

Figure 3. Subareolar region.
Republished with permission from the professional education unit cancer detection section, California Department of Health Services.

Supernumerary nipples and/or breasts and inverted nipples are congenital conditions that occur in about 10% of the population. Supernumerary nipples occur along the milkline and are sometimes mistaken for skin tags or moles (Figure 4). Neoplasms can occur in supernumerary breasts and should be screened and diagnosed in the same manner as usual breast cancer (CBE, imaging or minimally invasive biopsy[2]).

Figure 4. Supernumerary nipples are sometimes mistaken for skin tags or moles.
Graphic republished with permission from Hindle, William H. Breast Care: A Clinical Guidebook for Women's Primary Health Care Providers. New York, NY: Springer-Verlag; 1999.

Breast cancer can occur anywhere within the breast perimeter, including in supernumerary breast tissue anywhere along the milkline. Most breast cancers occur in the upper outer quadrant and subareola region because that is where most of the tissue is located. (Figure 5).

Figure 5. Upper outer quadrant of the breast.
Republished with permission from the professional education unit cancer detection section, California Department of Health Services.