Breast’s Anatomy: What Makes Up a Breast?

Image to the left taken from emedicine.medscape.com.

Breasts are milk-producing (mammary) glands surrounded by fat and are attached to the front of the chest by ligaments. The breast rests on the pectoralis major chest muscle, but has no muscle tissue itself. The fat in the breasts determines their shape and size, which varies among women even though the size of the mammary gland system is relatively standard. In addition, women commonly have one breast that is larger than the other.

Breasts begin developing between the ages of 9 and 14 for most girls, and signal the start of puberty. Breast tissue is highly sensitive to the hormones estrogen, progesterone, and prolactin throughout the menstrual cycle. While breastfeeding, prolactin triggers milk production within the breast, and its anatomy is simple yet complex.

Lobules, Alveoli, and Ducts

Breasts have 15 to 20 sections known as lobes or lobules that converge at the nipple. Each lobule consists of hollow sacs called alveoli, and the lobules are connected through ducts. The final collection area for milk is known as the main duct.

During breastfeeding, prolactin stimulates the alveoli to pull nutrients from the woman’s blood to produce breast milk, and oxytocin causes the alveoli to release the milk through the mammary ducts to the nipple.

Nipple

Also known as the mammary papilla, the nipple is the outlet for the mammary ducts and where milk is secreted.

Areola

Often included when referring to the nipple, the areola is the round pigmented area surrounding the nipple. During breastfeeding, small bumps on the areola known as Montgomery glands produce an oily substance that cleans and lubricates the nipple.

Lymph Nodes and Ducts

The lymphatic system helps fight infection by capturing and excreting pathogens and toxins through lymph nodes and ducts. These nodes are found near the breast, in the armpit, and behind the breastbone. Often, axillary (armpit) lymph nodes are removed during mastectomy.

Cooper’s Ligament

This ligament is often called “nature’s bra” because it lifts the breast and prevents it from sagging.

For a slideshow on breast anatomy, visit http://www.mayoclinic.com/health/breast-cancer-early-stage/BC00001.

Have questions about breast cancer? Visit our blog’s Ask the Doctor section.

Do You Know Your Breast Reconstruction Options?

breast reconstruction optionsWe’re thrilled to share some exciting news with you, today! Dr. Richard Kline, Charleston breast surgeon, and the lovely Leslie Haywood, owner of Grill Charms™ and breast cancer survivor, were recently interviewed on one of our local Charleston news channels. During this interview, Leslie shares her inspirational story of breast cancer survival and how she chose to have the breast surgeons of The Center for Natural Breast Reconstruction perform her natural breast reconstruction.

Dr. Richard Kline of The Center for Natural Breast Reconstruction spoke about breast reconstruction options for women who are currently undergoing treatment for breast cancer or who have had a mastectomy.

See below for the interview:

If you want to learn even more about Leslie Haywood’s story (and get a chuckle from her hilarious narrative), click here to view one of our recent blog interviews with her.

For those of you who aren’t aware of The Center for Natural Breast Reconstruction and what we do, here’s a brief description:

Charleston plastic surgeons Dr. James Craigie and Dr. Richard Kline specialize in breast reconstruction for women who have undergone mastectomy and those who are considering risk reducing prophylactic surgery. Some of the procedures performed by these Charleston breast surgeons include DIEP, SIEA, and GAP free flap breast reconstruction, which utilize your own tissue with no implants and no muscle sacrifice.

Our Charleston breast surgeons also perform nipple sparing mastectomy, reconstruction after lumpectomy, microsurgical breast reconstruction, and breast restoration. Visit The Center for Natural Breast Reconstruction website at http://www.naturalbreastreconstruction.com/.

Weird Breast Issues That Aren’t Really Weird At All

breast changesFrom nipple leakage to uneven sizes, our breasts often confuse or scare us. Most of the time, what appears to be a breast problem isn’t a problem at all, but a completely normal occurrence. Breast information isn’t at the forefront of the news unless it’s connected to cancer, so we don’t receive much information about breast issues that aren’t serious.

The following breast issues are typically normal, even though they may seem odd. Let us stress that if you have questions about any breast issue, or feel that something isn’t right, do not hesitate to call your doctor. Always listen to your gut and intuition.

Uneven breast sizes

If you look closely at other parts of your body that come in pairs, such as your eyes, hands, and feet, you’ll see that each one of the pair is different from the other, and this includes your breasts. Some women may find that one breast is a size or two different from the other, and this is normal.

Lumpy breasts

Have you ever driven yourself crazy because you think you’ve found several lumps during a self-exam? This one can be scary, but for some women, lumps are a normal part of their breast tissue. Called fibrocystic breasts, this noncancerous condition is very common, especially among premenopausal women. Dense breast tissue tends to feel lumpy, which is one more reason to know what is normal for your breasts and do thorough monthly self-exams.

Nipple leakage when you’re not pregnant

Nipple leakage is common, and fluid can be almost any color or consistency. Some women experience spontaneous leakage, while for others, the leakage occurs only if the nipple is stimulated. Rarely, leakage signals something more serious, so check with your doctor if you’re concerned or it regularly occurs spontaneously.

Extra nipples

Some men and women are born with extra nipples, much as female animals have. According to Texas ob-gyn Michael Yang, MD, when a fetus forms, it has a milk line with several nipples that runs from the armpits down to the groin. Extra nipples typically disappear before birth, but some don’t, and their appearance ranges from molelike to actual miniature breasts.

Menstrual cycle-related breast changes

Thank your hormones for those breast changes during the month. Estrogen and progesterone increase and decrease during your cycle, which can cause breast tenderness and nipple soreness. If your breasts are unbearably sore, ask your doctor for advice on nutritional support.

Weight gain or loss from breasts

Speaking of breast changes, women often lament the fact that when they lose weight, it comes from their breasts first. Because breasts are mostly fat, it’s normal for them to change size when you lose weight.

Again, call your doctor with any breast-related concerns or questions.

How One Cancer Survivor Embraces Life After Cancer

Debbie Woodbury

Debbie Woodbury

We are not only delighted, but we are also extremely honored to introduce our In Her Words guest blogger for today, Debbie Woodbury. As a cancer survivor, blogger, speaker, and advocate, Debbie has become an inspiration to all women—no matter their age or health history. In our interview with Debbie, she talks about her amazing blog, Where We Go Now, and discusses the benefits she, as well as her loyal readers, receive from reading her blog.

See below for our exclusive interview with Debbie:

1. Where We Go Now is a completely unique blog that acts like a community and resource for women. Who is Where We Go Now for and what benefits do you hope readers get from visiting your blog?

Thank you so much for inviting me to lend my voice to In Her WordsWhereWeGoNow.com was created for cancer survivors exploring the gifts and losses of life beyond cancer. The idea for the site came from my own journey. About nine months after my mastectomy, I startled to realize I was keeping a tally in my head of the changes cancer was bringing me. Although I was excruciatingly aware of the losses, I was begrudgingly recognizing gifts. When I could ignore the gifts no longer, I decided to write them down side by side with the losses.

The losses were obvious, but there were a surprising number of gifts. Introspection, closer relationships, discovering yoga and meditation, making new friends, becoming aware of the present moment, learning to say “yes” to myself, and writing—just to name a few.

That list is now the heart of WhereWeGoNow.com. We’ve all taken major, earth-shattering losses, but I hope readers visiting WhereWeGoNow.com are inspired to recognize cancer’s gifts in their own lives. The most beautiful entries readers have posted are found at the Community Gifts and Losses List page. My Gifts and Losses List helped me find emotional healing and balance after cancer and I hope readers visiting WhereWeGoNow.com receive the same benefit.

2. What benefits do you receive from blogging about your life after cancer? (i.e. clarity, joy in helping others, etc.)

With each blog post I write, I still manage to surprise myself by writing down a thought I didn’t know I had until it hit the screen. Blogging brings me a deeper understanding of what I went through, and continue to experience, because of cancer.

Blogging also taught me that survivorship is a multi-faceted, life-long journey. I’ve blogged about my “beautiful,” eloquent cancer scars; yoga; how giving back to others helped me heal from cancer depression; awful summers and moving beyond them; my first survivors’ walk, the best thing anyone ever said to me about my cancer, and so much more.

Of all the posts I’ve written so far, however, I probably learned the most from the one I wrote about gratitude. I learned in writing that post, which I also gave as a speech, that I never would have recognized cancer’s gifts without gratitude, cancer’s first and most important gift to me.

The most wonderful part of blogging is getting comments back from my readers. It’s so gratifying to know my experiences have struck a chord with other survivors and perhaps made a difference in how they approach their survivorship. I will never say that cancer itself is a gift, because it is not. But recognizing the gifts it brought and continues to bring into my life is very healing for me.

Stay tuned for Part II of our interview with Debbie, which will publish this Wednesday, August 10!

About Debbie Woodbury:

Debbie Woodbury is a cancer survivor, blogger, speaker, and advocate. She entered the diagnostic and treatment phases of breast cancer in 2008. When she completed treatment in 2009, she was left to deal with cancer’s emotional impact. With the support of family, friends, and wonderful oncology therapists, she was able to create her Gifts and Losses List and eventually realize that “Survival > Existence.” The Gifts and Losses List became the heart of WhereWeGoNow.com, a community of survivors sharing the gifts and losses of lives lived beyond cancer.

Connect with Debbie on Twitter and Facebook.

Having a Positive Outlook on Life Before, During, & After Breast Cancer: Interview with Leslie Haywood

Leslie Haywood

Leslie Haywood

We are SO excited to share with you Part II of our interview with Leslie Haywood, creator of Grill Charms™. For those of you who have not yet read Part I of this interview, Leslie shared her story as a breast cancer survivor and explained how she started a successful company while undergoing treatments.

We absolutely love how Leslie can be so inspirational and funny at the same time!

If you missed Part I of this interview, click here.

See below for Part II of our exclusive and highly inspirational (not to mention, hilarious!) interview with Leslie Haywood:

1. Your first Grill Charms™ sale was somewhat unexpected! Tell us where you were and how you sold your first Grill Charms™.

Oh yes! My most memorable sale to date! I was in the office for my final “procedure,” if you will. I was in The Center for Natural Breast Reconstruction office for my nice pinkish brown tattoo. As you can imagine, I have known all the folks at Dr. Craigie’s office  for over a year by then (and  pretty intimately I must say), so in an effort to help me think about anything other than what she was doing, the nurse asked about how my brand new business was going. Her distraction technique worked! I instantly forgot the discomfort and gave her the complete rundown of Grill Charms™, ending with: “I have a set to show you in my purse over there!”

By the time the nurse was done waving her buzzing magic wand all over my reconstructed girl parts, she said “I need 5!”  I immediately jumped off the table (still half dressed), showed her the set out of my purse, and right then and there, with my cell phone calculator (yep, still topless) I totaled up everything plus tax and she wrote the check on the spot. After our business transaction was done, she helped me with the bandage / pad etc. and I put my clothes back on. I can’t imagine any other sale being quite as “interesting” as this one. Obviously I’m not opposed to be doing business topless, but thankfully I have not had to resort to that since!

 

Grill Charms pink collection

Grill Charms Pink Collection

5. How did you decide which type of breast reconstruction surgery you wanted?

Because of my family history, I feel like I was at an “advantage” (if you can call it that!). I have had YEARS to consider and decide how I would handle a breast cancer diagnosis. Back when my mother had her treatment and reconstruction, there were very few options and she pretty much did what she was told (mastectomy and implant).

I saw what 20 years had done to her reconstruction and had always wanted better for myself. I didn’t like the idea of an implant being in me for all eternity and also knew that I wanted “symmetry” for the rest of my life, so both boobs would HAVE TO GO! The fact that my “baby pooch” would be used to make my new breasts and the fact that I’d have the stomach I used to have in my 20’s, was a BONUS!

Oh, another little story about the surgery (**For those of you who know me, you know I’m the queen of TMI, so you’ll have to excuse my “frankness” when it comes to what some might view as sensitive topics. I apologize if my candor and tone offends anyone.).  Okay… so when the decision was made and we knew that “natural breast reconstruction” was the way to go, and that “belly fat” was where my new breasts were going to come from, I talked to my husband about “size.”  He said “porn star, please” and I said “NO WAY,” but I did want something to show off.  I really wanted to make sure that Dr. Craigie had enough “material” to work with, so I went on an 8-week eating FRENZY!

My family would watch me getting 2nds and 3rds of my favorite food, STEAK! They’d say “Leslie . . . slow down there girl!” and my reply was always the same, “Shut up! I’M MAKING BOOBIES!” For those 8 weeks, food and I had a magical relationship! Ahhh…. I miss those days!

Now what I DID NOT take into account with natural breast reconstruction was how my breasts would look after the surgery. With my tummy flat and my new natural breasts a fabulous B+ maybe C, I wanted do right by my “second chance” and  eat right and exercise to keep it. I have never been more fit in all my life! BUT, because the new breasts are “all natural,” when I started to lose all that “boobie making weight” and toned everything up, my new breasts acted exactly like my old ones. There was a little shrinkage factor! So now I’m more like an A+ to a B-, but I have never been happier with my body and I have never been more in shape in my entire life! Just look how awesome they are! THANKS Dr. Baron for saving my life and thanks Dr.Craigie for making me look and feel better than ever!

6. What would you tell women who have had a mastectomy or are planning on undergoing one about natural breast reconstruction?

You owe it to yourself to at least learn about natural breast reconstruction and fully understand this option. Knowledge is power and you will never regret finding out about what you don’t know. There has not been a single SECOND that I wish that I had done things any differently. Natural breast reconstruction was the absolute best option for me, NO QUESTION!

About Leslie Haywood and Grill Charms™:

Leslie Haywood is founder and President of Charmed Life Products, LLC, and inventor of Grill Charms™. Leslie was a stay-at-home mom when a very spicy light bulb moment thrust her into the entrepreneurial ring. During the start up phase of her company, she was diagnosed with breast cancer, but still managed to launch her product on store shelves within 18 months and is now sold in over 400 stores internationally. She has been featured numerous times on CNBC, various local and regional news programs, as well as ABC’s prime time reality TV show Shark Tank seasons I and II. Her story and product have publicized in such magazines as Everyday with Rachael Ray, Parenting magazine, Health magazine, Inventors Digest, and was also featured on The Today Show. All the while she is mindful of “the cause,” whether it’s giving back through “The Pink Collection” of her gift and grilling accessory Grill Charms™, or her work as Honorary Chair for The Race for the Cure .

Leslie’s Special Offer:

***Put “natural” in the coupon code of www.grillcharms.com for 10% off!***

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Don’t Live in Charleston But Still Want a State-of-the-Art Breast Reconstruction?

Chris MurakamiThe question below is answered by Chris Murakami, RN, CNOR, and Clinical Supervisor (seen to the left) of The Center for Natural Breast Reconstruction.

I live in Florida and would like to come to Charleston to have a bilateral S-GAP by Dr. Kline and Dr. Craigie. Do I need to come in for a consultation first and then come back at a later date to have the surgery or can it be done all in one trip? Please tell me how this is typically handled.

Great question! There are many ways to approach this situation and do our best to try to minimize the number of trips you need to make to Charleston. You are more than welcome to come and have a face to face consult with your surgeon and then make a second trip for surgery. For some women, that is the scenario they prefer. However, since many of our patients do have to travel to access the state-of-the-art procedures offered by our expert surgeons, we’re prepared to perform your first consultation by telephone.

During this call, we talk about the procedure you are interested in and ask some screening questions to ensure you have no medical contraindication. Once this has been established, we’ll set up a time for you to talk with the surgeon of your choice and you’ll both decide which donor site might be the best to use for your breast reconstruction. Your next step would be to notify us when you would like to proceed with the surgical procedure.

When we’ve settled on a surgical date, we order as much of your pre-operative testing in your hometown as we can. The results of this testing is sent to our office two weeks prior to your surgery day. These tests include blood work, urinalysis, EKG, and Chest X-ray. Go ahead and schedule a full physical with your family doctor or internal medicine doctor and obtain a statement of medical clearance for your estimated length of surgical time.

While all of this medical work is happening, our administrative staff has been diligently working behind the scenes, checking insurance benefits and completing all of the pre-certification processes your insurance company may require.

We’d like you to arrive in Charleston a day or two prior to your surgery date. If a breast surgeon is needed to perform a mastectomy we ask you to come two days prior. You would meet with him / her on the day you arrive, in case any testing needs to be ordered by their office.

The day prior to your surgery date is usually the busiest for you, but we try to coordinate all of your pre-operative activities to be as convenient as possible. You would have various appointments scheduled for you, including a pre-operative interview at the surgical hospital, an MRA to map the blood vessels we plan to use for surgery, and a pre-operative marking appointment and consultation with our surgeon that day before surgery.

Once the surgery day arrives, you would report to the hospital at 6:00 am. Our staff and physicians will obtain contact information for your caregivers and keep them updated on the progress of your surgery throughout your time in the operating room. Once the operation has completed and you have recovered from anesthesia, you would be transferred to the women’s services floor of the hospital for the remainder of your four-day hospitalization. Each room is private and has a twin bed in case you have someone who plans to stay with you throughout your hospital stay.

When you have been discharged from the hospital, we ask that you stay in the Charleston area for a few more days, just to assure all is well and we are easily accessible to you. We ask you to come to your first post operative appointment two days after your discharge and again on the day prior to your planned return home. You may still have donor site drains that need to be removed when you return home and we are happy to help you find a medical professional to do that for you if you don’t have a physician in your hometown who is willing to help.

Once you are home, we’re available to you 24/7 to discuss any concerns you may have, but generally, at this point, you have a viable reconstruction that should heal uneventfully. You can look forward to another visit to Charleston only when or if you require a second stage of surgery after a three-month healing period. This procedure would typically be an outpatient procedure and you might just schedule yourself some “tourist time” to enjoy our beautiful city.

—Chris Murakami, RN, CNOR, Clinical Supervisor

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Educate Yourself on Breast and Ovarian Cancer at the Annual Joining FORCEs Conference

Image to the left taken from FacingOurRisk.org.

For anyone concerned about hereditary breast or ovarian cancer, FORCE is hosting their annual Joining FORCEs Conference with Moffitt Cancer Center to educate individuals on everything from mastectomy options to genetic basics, and reconstruction options to menopause. This three-day international conference will provide attendees with valuable information and tips for cancer prevention and detection.

Attendees will also learn vital skills such as how to cope with cancer, how to make risk-management decisions, how to discuss cancer with family members, and so much more.

The event takes place from June 23 – 25 at the Hyatt Regency Grand Cypress in Orlando, Florida. And we are delighted to inform you that we’ll be attending the event and featured as one of the exhibitors. In addition to exhibiting, Dr. James Craigie will be on one of the reconstruction Q & A panels, and Dr. Richard Kline will be hosting a table at the Networking Breakfast. We hope to see you there!

See below for an amazing video from FORCE:

Click here to register for this amazing event!

Does Radiation Affect My Options For Breast Reconstruction?

Dr. James Craigie

Dr. James Craigie

The question below is answered by Dr. James Craigie of The Center for Natural Breast Reconstruction.

I am not sure if I will need radiation after my mastectomy. What factors should I consider before going ahead with breast reconstruction?

Radiation therapy is part of the treatment for breast cancer for some but not all patients. To determine if it is necessary for any individual, the details of the cancer or the final path results must be known. The most common situation for radiation after mastectomy is based on the size of the cancer and the number of positive lymph nodes.

When a patient would benefit from radiation the treatment may affect the options for breast reconstruction as well as the timing of the reconstruction. There are several advantages to starting the breast reconstruction at the time of the mastectomy. These include: the breast surgeon can save more of the breast skin or even the nipple and this can set the stage for the best possible result, and avoiding an extra step and an extra recovery period.

If radiation will definitely be needed after mastectomy then I do not recommend immediate natural breast reconstruction because the radiation can possibly damage the new breast. In this situation the reconstruction would start approximately 6 months following radiation. These decisions are best made following the advice of your oncologist, breast surgeon, and plastic surgeon all working together. For this reason I am a strong advocate of the multi-specialty breast conference where each patient can be presented to all the specialists at once so they can share their opinions right away. Cooperation between experts can ensure better results and more options for each patient.

It is important to remember that if you need radiation for the treatment of breast cancer it does not mean you cannot have a very good result with natural breast reconstruction. It may however determine the order and timing of when the breast reconstruction should begin.

—James E. Craigie, MD

 

Important Self-Exams Every Woman Should Perform

Image to the left taken from Cancer.org.

 

Self-exams help you to detect changes in your body between visits to your doctor. Many lives have been saved due to diligent self-examination, and following are two self-exams you’ll want to perform regularly.

BSE or breast self-exam

Each woman has her own method of examining her breasts. Some do a systematic BSE monthly or bimonthly, while others keep an eye on their breasts by regularly feeling them in the shower or while lying in bed. Often, women ask their significant others to help them check, or they visit the doctor several times a year for a clinical exam.

While a regular BSE with a consistent technique is best, perfect technique is not as important as frequency and diligence. Sometimes, women stress needlessly about doing it correctly. As long as you feel the entire breast and overlap your motions, you’re doing it right. The goal of a BSE is to know what is normal for you and check for changes.

If you’re not sure whether you’re feeling the entire breast, cancer.org suggests the following BSE routine:

  • Lie down and bend your arm behind your head to spread the breast tissue evenly over your chest, making it easier to examine.
  • Imagine your breast is divided in vertical lines from your underarm to breastbone, and use the finger pads of your other hand to feel for lumps in an up-and-down pattern along those lines. Move in dime-sized circles, slightly overlapping the previous line as you move up and down.
  • Use different levels of pressure at each spot so you feel all the breast tissue, especially if you have large breasts. You can feel the tissue close to the skin with light pressure, tissue in the upper half of the breast with medium pressure, and lower breast tissue with deeper pressure. There will be a ridge at the bottom of each breast, which is normal. If you have questions about pressure, talk with your doctor or nurse.
  • Examine the entire breast area, and then repeat the exam on your other breast.
  • Stand in front of a mirror, press your hands on your hips, and look at your breasts for changes in shape or size. Also look for rashes, redness, or dimpling.
  • Raise each arm slightly, and feel the underarm for lumps.

Some women may find it easier to examine their breasts in the shower, which is fine, as long as you are thorough—or add this routine to your shower exam. Current medical literature suggests that the above procedure is the most effective for finding lumps as soon as possible.

Skin exam

A regular skin exam will help you keep an eye on moles, freckles, and other spots that could become cancerous. It should be done at least once a month, and if you ask your doctor to do a full-body exam first, you’ll have a baseline. While it may sound daunting, after you’ve done a full skin exam a couple of times, it shouldn’t take more than 10–15 minutes.

Warning signs of skin cancer include a change in an existing mole or spot, or any growth or spot that . . .

  • Appears during adulthood.
  • Increases in size or thickness.
  • Changes in texture or in color—especially if it turns pearly, multicolored, brown, or black.
  • Has an irregular shape or outline.
  • Is bigger than a pencil eraser.
  • Continues to hurt, itch, scab, or bleed longer than three weeks.

If you see any of these signs, don’t wait or hope it goes away. See a doctor, preferably a dermatologist.

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A Journey You Don’t Have to Take Alone

breast cancer survivor

Shirley's book cover

Dear Sister in this Journey,

My name is Shirley. I have just undergone a double mastectomy and breast reconstructive surgery as a result of having breast cancer. I am one of the fortunate ones who did not have to endure chemotherapy, as well.

My cancer was in my left breast, but I chose to have a double mastectomy to mitigate future risk of recurrence.  Based on the reputation and firsthand knowledge I had of Dr. Kline and Dr. Craigie, I chose the Center for Natural Breast Reconstruction to take care of my small, but precious bosoms.

Once the decision was made to move forward with bilateral DIEP reconstruction surgery, I was given a patient handbook that provided information about what to do pre and post surgery. No offense to the medical team that put together a technically comprehensive document, but boy did they leave out a lot of information that would have been helpful! The kinds of things that, really, only a patient would know.

So, I thought I’d write about my personal experiences to share with others—maybe it will help those who are about to undergo a DIEP reconstruction procedure to be more prepared and know more about what to expect. If you would like a copy of my booklet, get in touch with the center at www.naturalbreastreconstruction.com, they’ll be happy to give you one.

It’s all from my perspective and I hope it helps in understanding what will happen. And I hope it helps keep others positive as they face the surgery.

Good luck on your Journey!

Most sincerely,

Shirley Trainor-Thomas

Breast Cancer Survivor

Hodgkin’s Lymphoma Survivor

Reconstruction Success Story

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