Meeting Abstract

P3-32   -   The principles of ventral body wall formation explain the gross anatomy of the human breast Suarez-Venot, AG*; Lindvall, TJ; Rodriguez-Sosa, JR; Plochoki, JH; Grossman, A; Valdez, DR; Georgi, JA; Hall, MI; Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ; Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ; College of Graduate Studies, Midwestern University, Glendale, AZ; Department of Medical Education, College of Medicine, University of Central Florida, Orlando, FL; College of Graduate Studies, Midwestern University, Glendale, AZ; College of Graduate Studies, Midwestern University, Glendale, AZ; Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ; College of Graduate Studies, Midwestern University, Glendale, AZ asuarez-venot97@midwestern.edu

Mammary glands define mammals together as a group; yet, a comprehensive anatomical description does not exist for almost any mammal. In humans, the anatomical and surgical literature provide conflicting and incomplete descriptions of the gross anatomy of the breast. We dissected 7 male and 12 female cadaveric specimens to clarify this gross anatomy. We found that, like other epidermally derived glands of the body, the mammary glandular tissue is constrained to a membrane-bound, central structure referred to as the corpus mammae in the surgical literature, and is not dispersed throughout the breast as described in the anatomical literature. The major fasciae of the human ventral body wall, including the superficial fatty Camper’s fascia and the deeper membranous Scarpa’s fascia, both contribute to the structure of the breast. We propose that during embryological development the mammary gland grows dorsally from the integument, pushing Camper’s and Scarpa’s fasciae ahead of it. When the mammary gland reaches the rigid thoracic wall, the gland grows laterally, pulling along Camper’s fascia to create the fat of the breast. Ventrally Scarpa’s fascia becomes a double layer that creates both the surface structure of the breast and dorsally Scarpa’s forms a circummammary ligament that 1) stabilizes the breast against the thoracic wall and 2) is continuous with Scarpa’s fascia on the rest of the ventral body wall. The suspensory ligaments of the breast (named Cooper's ligaments in surgical literature) represent the typical, albeit thickened, septations between fat lobules found consistently throughout the human body, and do not attach to the skin. Instead, these ligaments attach to Scarpa’s fascia.