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Subject:
From:
"Kermaline J. Cotterman" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 7 Aug 2002 14:39:52 -0400
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<Jean (and any others who might know)
Has MRI been used to look at the structure of the breast?>

Some ultrasound texts and articles, and some embryology and a few medical
texts about breast development and breast disease form most of the basis
for the small amount I know about the enormous subject of breast
structure at different stages in life. Remember, the breast is the only
organ that is not completely developed at birth.

That being said, I believe MRI is done with actual x-rays, whereas
ultrasound is not. For that reason alone, I would think one would only
"research" with MRI if there were a legitimate need for diagnostic
information. Too much potential for tissue destruction/tumor formation
with repeated exposure to x-rays I have heard. Curiosity is not
sufficient reason to take this risk.

There is a diagnostic ultrasound procedure called ductography in which a
cannula is painlessly placed through the nipple pore and a dye is
injected into a duct to allow visualization of its shape, course and
diameter. (If anyone has a relative who is a diagnostic radiologist,
maybe such a study of just one duct with photographs of the result
wouldn't even require much funding. I would suspect that simply
expressing would remove the dye!! Volunteer pregnant and lactating
models, anyone? Maybe not just kidding.)

Lanfranchi ME, Chapter 7: Ultrasound examination
of ducts,  Breast Ultrasound, 2000, Marban Books, New York, NY
           Great ultrasound of ducts (p.17)

I do think that facilitating communication between the lactation
community and the forensic pathology/breast surgery/medical school
anatomy lab community might alert them to the fact that they can supply
valuable information to us specifically, if they are aware of precisely
what controversies we are debating, what processes we are wanting to
study, etc. Any professionals, physicians especially, who have
connections with those communities, should be asked to spread the word
and some articles about new research and controversy.

There was an interesting study done by Russo and Russo in which
(postmortem!) dissection of whole breasts of (43) women of different
reproductive histories and ages and developmental stages from pre-puberal
through postmenopausal  was represented in a most interesting graph.

(Every pregnancy, whether it only begins, and then ends prematurely
through any process, brings about a series of changes in breast tissue,
which involute at least partially if no lactation occurs.

And, commenting on another thread discussed this week, the breast
development advances somewhat with each menstral cycle, so despite her
chronological age or age of menarche, thelarche (breast development)
begins before actual menses, and the cumulative # of menstrual cycles a
young woman has undergone before her first pregnancy would have some
impact on the amount of breast tissue she had to "work with", at least at
the onset of the first pregnancy.)

The study described and the graph depicted what % of tissue was
connective (stroma) and what was glandular (parenchyma) and at what
development that glandular tissue was at various stages of reproductive
life.

I had to create a simple garden metaphor for myself while I was reading
it because I am still very much a novice at such deep reading. If S
stands for Soil and Stroma, and P stands for Plant and Parenchyma, then
you could imagine how the roots of a plant arborize into the soil, and
see the similarities of how the parenchyma arborizes into the stroma
during developmental processes of breast growth.

The graph also depicted the % of each that resulted with reversal of the
processes between pregnancy/lactation events.

It is well worth looking up.

Russo J, Russo IH, Development of the Human Mammary Gland in: The Mammary
Gland, Development, Regulation, and Function ed. by Neville MC, Daniels
CW 1987 Plenum Press, NY. pp 67-93.

Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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