Karleen wrote:
<Can you describe in a bit more detail what happens to the breast
structure
after menopause. I was under the impression that it all remained
functional, hence the ability of grandmothers to BF their grandchildren
when they are long past menopause themselves >
I guess it depends on when one's own menarche and childbearing occurred,
how young one's children were when they bestowed grandmotherhood on you,
and when your genetics "forecast" your own menopause to occur. (And who
knows how Hormone Replacement Therapy might change this?) Add 3-5 years
of a gradual process to that:
"Normal Involution
. . . . .Involution takes place after pregnancy and lactation, and
around the time of menopause. . . . The precise duration of the process
is not known but it appears to be of the order of three to five years.
This information is derived from sequential biopsies on near-normal
breasts, and from necropsy studies of 'normal' women around the time of
menopause. It can be considered, for convenience, under the headings of
lobular, ductal and stromal involution.
. . .the double-layered epithelium shrinks and becomes flattened while
the luminal space narrows and becomes almost obliterated and epithelial
secretion ceases. At the same time, the specialized mucoid loose
connective tissue of the lobule gradually becomes converted into dense,
hyaline collagen, which blends to varying degrees with the thickened
acinar basement membranes. . . The specialized connective tissue of the
lobule is lost and comes to resemble ordinary connective tissue. Because
of this, it merges with and 'sinks into' its background so that the
original lobular outline is lost without trace; in these circumstances,
only remnants of the epithelial tissue will indicate where the lobule has
been: when the epithelial remnants vanish, the lobule disappears as
completely as the Inca civilization."
Azzopardi, J.G., Ahmed, A., Millis, R.R., "Problems in Breast Pathology"
in Major Problems in Pathology, Bennington, J.L. (Ed.) 1979, W.B.
Saunders, Philadelphia p.17.
Another reference has five pairs of comparative pie-chart representations
illustrating variations in kinds of tissue in the breast, but only from
the prepubertal period to the end of pregnancy:
Russo, J. and Russo, I.H., Development of the Human Mammary Gland, in The
Mammary Gland: Development, Regulation and Function, (Ed.) by Neville,
M.C. and Daniel, C. W. 1987 Plenum Press, NY, p. 89.
Many disciplines (embryology, dermatology, pathology, surgery [both
breast disease and plastic], and now radiology and ultrasound) have been
exploring and writing about other aspects of the human breast for a
century or more.
Amazing what interesting factoids there are to be found that can augment
lactational knowledge.
Jean
**********
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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