Breast


The breasts are two prominences located on the upper ventral region of the torso among humans and other primates. Both sexes develop breasts from the same embryological tissues. The relative size and development of the breasts is a major secondary sex distinction between females and males. There is also considerable variation in size between individuals. Permanent breast growth during puberty is caused by estrogens in conjunction with the growth hormone. Female humans are the only mammals that permanently develop breasts at puberty; all other mammals develop their mammary tissue during the latter period of pregnancy.
In females, the breast serves as the mammary gland, which produces and secretes milk to feed infants. Subcutaneous fat covers and envelops a network of ducts that converge on the nipple, and these tissues give the breast its distinct size and globular shape. At the ends of the ducts are lobules, or clusters of alveoli, where milk is produced and stored in response to hormonal signals. During pregnancy, the breast responds to a complex interaction of hormones, including estrogens, progesterone, and prolactin, that mediate the completion of its development, namely lobuloalveolar maturation, in preparation of lactation and breastfeeding.
Along with their major function in providing nutrition for infants, breasts can figure prominently in the perception of a woman's body and sexual attractiveness. Breasts, especially the nipples, can be an erogenous zone, and part of sexual activity. Some cultures ascribe social and sexual characteristics to female breasts, and may regard bare breasts in public as immodest or indecent. Breasts can represent fertility, femininity, or abundance. Breasts have been featured in ancient and modern sculpture, art, and photography.

Etymology and terminology

The English word breast derives from the Old English word brēost from Proto-Germanic breustam, from the Proto-Indo-European base bhreus–. The breast spelling conforms to the Scottish and North English dialectal pronunciations. The Merriam-Webster Dictionary states that "Middle English brest, from Old English brēost; akin to Old High German brust..., Old Irish brú , Russian bryukho"; the first known usage of the term was before the 12th century.
Breasts is often used to refer to female breasts in particular, though the stricter anatomical term refers to the same region on members of either sex. Male breasts are sometimes referred to in the singular to mean the collective upper chest area, whereas female breasts are referred to in the plural unless speaking of a specific left or right breast.
A large number of colloquial terms for female breasts are used in English, ranging from fairly polite terms to vulgar or slang. Some vulgar slang expressions may be considered to be derogatory or sexist to women.

Evolutionary development

Humans are the only mammals whose breasts become permanently enlarged after sexual maturity. The reason for this evolutionary change is unknown. Several hypotheses have been put forward:
A link has been proposed to processes for synthesizing the endogenous steroid hormone precursor dehydroepiandrosterone which takes place in fat rich regions of the body like the buttocks and breasts. These contributed to human brain development and played a part in increasing brain size. Breast enlargement may for this purpose have occurred as early as Homo ergaster. Other breast formation hypotheses may have then taken over as principal drivers.
It has been suggested by zoologists Avishag and Amotz Zahavi that the size of the human breasts can be explained by the handicap theory of sexual dimorphism. This would see the explanation for larger breasts as them being an honest display of the women's health and ability to grow and carry them in her life. Prospective mates can then evaluate the genes of a potential mate for their ability to sustain her health even with the additional energy demanding burden she is carrying.
The zoologist Desmond Morris describes a sociobiological approach in his science book The Naked Ape. He suggests, by making comparisons with the other primates, that breasts evolved to replace swelling buttocks as a sex signal of ovulation. He notes how humans have, relatively speaking, large penises as well as large breasts. Furthermore, early humans adopted bipedalism and face-to-face coitus. He therefore suggested enlarged sexual signals helped maintain the bond between a mated male and female even though they performed different duties and therefore were separated for lengths of time.
A 2001 study proposed that the rounded shape of a woman's breast evolved to prevent the sucking infant offspring from suffocating while feeding at the teat; that is, because of the human infant's small jaw, which did not project from the face to reach the nipple, they might block the nostrils against the mother's breast if it were of a flatter form. Theoretically, as the human jaw receded into the face, the woman's body compensated with round breasts.
Ashley Montagu proposed that breasts came about as an adaptation for infant feeding for a different reason, as early human ancestors adopted bipedalism and the loss of body hair. Human upright stance meant infants must be carried at the hip or shoulder instead of on the back as in the apes. This gives the infant less opportunity to find the nipple or the purchase to cling on to the mother's body hair. The mobility of the nipple on a large breast in most human females gives the infant more ability to find it, grasp it and feed.
Other suggestions include simply that permanent breasts attracted mates, that "pendulous" breasts gave infants something to cling to, or that permanent breasts shared the function of a camel's hump, to store fat as an energy reserve.

Structure

In women, the breasts overlie the pectoralis major muscles and extend on average from the level of the second rib to the level of the sixth rib in the front of the rib cage; thus, the breasts cover much of the chest area and the chest walls. At the front of the chest, the breast tissue can extend from the clavicle to the middle of the sternum. At the sides of the chest, the breast tissue can extend into the axilla, and can reach as far to the back as the latissimus dorsi muscle, extending from the lower back to the humerus bone. As a mammary gland, the breast is composed of differing layers of tissue, predominantly two types: adipose tissue; and glandular tissue, which affects the lactation functions of the breasts. The natural resonant frequency of the human breast is about 2 hertz.
Morphologically, the breast is tear-shaped. The superficial tissue layer is separated from the skin by 0.5–2.5 cm of subcutaneous fat. The suspensory Cooper's ligaments are fibrous-tissue prolongations that radiate from the superficial fascia to the skin envelope. The female adult breast contains 14–18 irregular lactiferous lobes that converge at the nipple. The 2.0–4.5 mm milk ducts are immediately surrounded with dense connective tissue that support the glands. Milk exits the breast through the nipple, which is surrounded by a pigmented area of skin called the areola. The size of the areola can vary widely among women. The areola contains modified sweat glands known as Montgomery's glands. These glands secrete oily fluid that lubricate and protect the nipple during breastfeeding. Volatile compounds in these secretions may also serve as an olfactory stimulus for the newborn's appetite.
The dimensions and weight of the breast vary widely among women. A small-to-medium-sized breast weighs 500 grams or less, and a large breast can weigh approximately 750 to 1,000 grams or more. In terms of composition, the breasts are about 80 to 90% stromal tissue, while epithelial or glandular tissue only accounts for about 10 to 20% of the volume of the breasts. The tissue composition ratios of the breast also vary among women. Some women's breasts have a higher proportion of glandular tissue than of adipose or connective tissues. The fat-to-connective-tissue ratio determines the density or firmness of the breast. During a woman's life, her breasts change size, shape, and weight due to hormonal changes during puberty, the menstrual cycle, pregnancy, breastfeeding, and menopause.

Glandular structure

The breast is an apocrine gland that produces the milk used to feed an infant. The nipple of the breast is surrounded by the areola. The areola has many sebaceous glands, and the skin color varies from pink to dark brown. The basic units of the breast are the terminal duct lobular units, which produce the fatty breast milk. They give the breast its offspring-feeding functions as a mammary gland. They are distributed throughout the body of the breast. Approximately two-thirds of the lactiferous tissue is within 30 mm of the base of the nipple. The terminal lactiferous ducts drain the milk from TDLUs into 4–18 lactiferous ducts, which drain to the nipple. The milk-glands-to-fat ratio is 2:1 in a lactating woman, and 1:1 in a non-lactating woman. In addition to the milk glands, the breast is also composed of connective tissues, white fat, and the suspensory Cooper's ligaments. Sensation in the breast is provided by the peripheral nervous system innervation by means of the front and side cutaneous branches of the fourth-, fifth-, and sixth intercostal nerves. The T-4 nerve, which innervates the dermatomic area, supplies sensation to the nipple-areola complex.

Lymphatic drainage

Approximately 75% of the lymph from the breast travels to the axillary lymph nodes on the same side of the body, while 25% of the lymph travels to the parasternal nodes. A small amount of remaining lymph travels to the other breast and to the abdominal lymph nodes. The subareolar region has a lymphatic plexus known as the "subareolar plexus of Sappey". The axillary lymph nodes include the pectoral, subscapular, and humeral lymph-node groups, which drain to the central axillary lymph nodes and to the apical axillary lymph nodes. The lymphatic drainage of the breasts is especially relevant to oncology because breast cancer is common to the mammary gland, and cancer cells can metastasize from a tumor and be dispersed to other parts of the body by means of the lymphatic system.