<I would love to see these references and pictures as you describe.> Azzopardi JG, Ahmed A, Millis RR. Nomenclature of the Microanatomy of the Breast: Parts Affected in Different Diseases: Normal Structure and Involution, In: Problems in Breast Pathology In: Major Problems in Pathology, Vol. 11 in series, Bennington JL, Ed., W. B. Saunders Co. Ltd., London, 1979. p. 9, 81, 335, 384. Haagensen CD, Diseases of the Breast, Third Edition 1986 W.B. Saunders Co: West Washington Square, Philadelphia, PA 19105, p. 10-12. <Also what are the certain disease processes that affect just the lactiferous sinuses?> Lactiferous fistula. Passaro ME, Broughan TA, Sebek BA, Esselstyn CB Jr. J Am Coll Surg. 1994 Jan;178(1):29-32. <Lactiferous fistula, or Zuska's disease, is a rare recurrent condition characterized by draining abscesses about the nipple on one or both breasts. Because little is known about the disease, it is often misdiagnosed and inappropriately treated.> < On histologic examination, we found that, in all instances, keratinizing squamous epithelium had replaced the lining of one or more lactiferous ducts for a variable distance into the subareolar tissue.> In rereading the abstract, I see the words "lactiferous sinus" are not actually mentioned. I'm sure I jumped to the conclusion that the condition happened in the lactiferous sinuses, because they are the last part of the ductal system ending in the subareolar area and normally lined with cuboidal cells. At the junction of the lactiferous sinus with the galactophore or collecting duct (which passes from the subareolar area through the nipple and exits at the tip of the nipple), the lining cell type normally changes abruptly to keratinizing squamous epithelial cells which continue onto the skin surface of the nipple and the rest of our bodies. In the resting breast, the collecting duct is plugged with the debris of desquamated keratin cells. I find this fact highly significant. As the breast begins to manufacture colostrum from mid-pregnancy on, in my mind's eye, I can see the droplets beginning to collect in the contracted sinuses, eventually "backing up" a little when it meets the junction, thus beginning to dilate the sinus and produce the bulge prenatally. I am 100% positive in my mind that that is what I have been palpating in thousands of breasts from the time I began to do prenatal nipple function assessments in the early 1970's. When I attended one of Chele Marmet's seminars where she taught fingertip expression using volunteer nursing mothers, I remember remarking to myself "Why these don't feel anything like I feel on moms during the mid-3rd trimester and early puerpuerium!" I have it figured out that weeks of nursing or pumping, by the principle of tissue expansion, must cause them to reach their full elasticity and respond easily to the forces of MER and suckling that fill and empty them. Therefore, at full, established lactation, ultrasound must reveal no more bulging than what occurs to the rest of the ducts, and they feel no different from the rest of the ducts when palpated. <I am not saying they are not present but what I saw on ultrasound right next to the nipple was no ballooning out sinuses.> That's why I said in my previous post: <What is missing from our understanding, it seems to me, is the process that happens to the sinuses from the time they are seen two-dimensionally under a microscope, contracted, in the non-pregnant breast, until the time they are well expanded in full lactation and "caught in the act of functioning" during these shadowy, still two dimensional ultrasound images. I maintain that between these two extremes are several stages where the "bulging" state naturally occurs. An experienced examiner can palpate them in most mothers from the mid-third trimester onward, and clearly feel their slight bulging throughout the first weeks and possibly months of lactation until they have developed their full elasticity and the contour the researchers describe at that point in time when these ultrasounds have been filmed. > < The breast structure and function has always fascinated me. > That makes at least two of us! For years, while I was palpating and demonstrating fingertip expression, I remember often saying to myself "That's strange! I wonder why this feels or acts different than the last several I palpated, etc. etc." Eventually, I began searching now and then in the medical libraries for clues in all kinds of journals and texts, and gradually found what I felt were satisfactory answers to my questions. Jean *********** K. Jean Cotterman RNC, IBCLC Dayton, Ohio USA *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html