406 Obstetrics and Gynecology Board Review •••
❍ Ductal proliferation is dependent on what hormone?
Estrogen.
❍ Lobuloalveolar development depends on what hormone?
Progesterone.
❍ What is the average number of lobes in the mature breast?
Each breast contains milk glands: 15 to 20 subdivided lobes of glandular tissue surrounded by fatty or fibrous tissue.
❍ A patient with bronchogenic carcinoma may present with what symptom relative to the breast?
Galactorrhea.
❍ How does a lactational breast abscess present?
It typically presents with pain, fever, and localized redness or warmth of the overlying skin. It is often difficult to
distinguish from mastitis. Clinical palpation will disclose focal tenderness with induration or a palpable mass.
❍ What is the most common infecting organism found in a lactational breast abscess?
Staphylococcus aureus.
❍ How is a lactational breast abscess treated?
Broad-spectrum oral antibiotic. The patient should be encouraged to continue nursing from both breasts and to
apply warm compresses to the tender area several times daily. An ultrasound examination of the breast should be
performed if there is no improvement by 48 to 72 hours after starting antibiotic treatment. Consideration should
be given to prompt surgical incision and drainage or ultrasound-guided percutaneous drainage if necessary.
❍ What are the most common locations of an abscess in a lactating breast?
The central and subareolar areas.
❍ What structure supports the breast tissue?
The skin ultimately supports the breast tissue along with a framework of fibrous, semielastic bands of tissue called
Cooper ligaments.
❍ What is the name of the staging system for breast development?
Tanner Stage 1 (prepubertal)—Papilla elevation only.
Tanner Stage 2—Breast buds palpable and areolae enlarge at age 10.9 years (8.9–12.9 years).
Tanner Stage 3—Elevation of breast contour; areolae enlarge at age 11.9 years (9.9–13.9 years).
Tanner Stage 4—Areolae form secondary mound on the breast at age 12.9 years (10.5–15.3 years).
Tanner Stage 5—Adult breast contour and areola recesses to general contour of breast (>15.3 years).
❍ What glands are present under the areola?
Montgomery glands.