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International Breastfeeding Journal encompasses all aspects of breastfeeding. The journal addresses the need for a high quality multi-disciplinary journal in the field. Breastfeeding is recognized as an important public health issue with enormous social and economic implications.
- Gross Anatomy of The Lactating Breast
- Ultrasound Equipment
- Scanning Technique
- Normal Ultrasonic Appearances of The Breast
- Blood Flow to The Lactating Breast
- Doppler Ultrasound of The Lactating Breast
- Ultrasound Doppler Technique
- Normal Ultrasonic Appearances and Blood Flow Parameters
- Lymphatics of The Breast
- Normal Appearances of The Lymphatics of The Breast
Standard descriptions of the human mammary gland are based on Cooper's dissections of the breasts of women who died during lactation (Figure 1) . Recently Ramsay and colleagues re-investigated the anatomy of the lactating breast using high-resolution ultrasound . We found fewer main ducts (mean 9; range 4–18) compared with the quoted 15–20 of conve...
Technical requirements
Breast ultrasound requires the highest resolution of almost all imaging procedures. In particular it requires high resolution of the near field (subcutaneous portion of the breast). The appropriate transducer is an electronically focused linear array with a frequency of 7–12 MHz with multiple focal zones to increase resolution of the area of interest . However, in the case of the large lactating breast a 5 MHz probe may be desirable to both increase penetration of the breast and improve f...
Ultrasound settings
The time compensation curve (compensates for the normal attenuation of the sound waves in the tissue) ranges between a gentle slope for predominately fatty breasts to a steep slope for dense breasts. The gain setting compensates for attenuation without discriminating for depth thus amplifying all of the returning echoes . Too high a setting will eliminate visualization of small structures and reduce the demarcation between adipose and glandular tissue. Too low a gain setting will result in...
Patient position
When investigating the non-lactating breast for abnormalities the patient is often placed in the posterior oblique position with the breast to be examined raised. The objective of this position is to flatten the breast and bring the internal structures more parallel to the ultrasound beam. Thus the degree of obliquity depends on the size and shape of the breast and may vary during scanning. Upright positions are used occasionally to determine if there is either floating debris or dependent le...
Compression
Moderate compression of the non lactating breast during scanning is often used for improving both image quality, by changing the orientation of normal tissue so that it is perpendicular to the insonating beam, and visualization of small masses located deep within the breast [18, 20] However, mild to moderate compression of the lactating breast will either compress or obliterate milk ducts thereby hindering visualization. It is prudent therefore to use moderate compression of the breast when t...
Palpation
Ultrasound can be targeted to the area of a palpable abnormality in both the non-lactating and lactating breast. Location of the abnormality and simultaneous scanning should elucidate any distortion of the normal structures of the breast. When no abnormality is detected comparison to the opposite breast may be useful. Further investigation should be considered in the absence of ultrasound changes.
The subcutaneous fat appears as a hypoechoic layer of tissue beneath the skin lines. Cooper's ligaments run between the superficial and deep fascia of the breast providing a framework for the parenchyma and appear as echogenic bands running obliquely from the posterior of the breast to the skin. The curved and fibrous nature of the ligaments may re...
The majority of the blood is supplied to the breast by two major arteries, the Internal Mammary Artery (IMA) and the Lateral Thoracic Artery (LTA). The IMA supplies the breast via the posterior and anterior medial branches and the Lateral Thoracic Artery supplies the lateral portion of the breast via the lateral mammary branch. Cooper depicted thre...
Many attempts have been made to determine if Colour Doppler Imaging can differentiate between benign and malignant masses with more accuracy than B-mode imaging alone. Results have been conflicting mainly due to many benign lesions exhibiting some vascularity .
The dominant mammary branch of the IMA can be located by positioning the transducer in a transverse plane alongside the sternum and making a sweep scan from the second to the sixth intercostal space. Colour Doppler imaging is essential to locate the IMA, which appears as a circular hypoechoic area between the rib spaces deep to the pectoral muscle....
The arteries and veins of the breast can be visualized and assessed with Colour Doppler ultrasound. In addition veins are occasionally imaged as anechoic tubular structures that compress with gentle pressure. During breastfeeding blood flow decreases by 40–50% just prior to milk ejection and then increases in the following one to two minutes . Spon...
The lymph in the breast is drained by two main pathways; to the axillary and internal mammary nodes [38, 39]. The axillary nodes have been reported to receive more than 75% of the lymph from both the medial and lateral portions of the breast , whereas, the internal mammary nodes receive lymph from the deep portion of the breast . Nevertheless ther...
There has been little investigation of the lymphatic drainage of the lactating breast despite its importance in clinical conditions such as engorgement and mastitis. Mammary nerves and normal lymphatics are not visualised on ultrasound, however when the lymphatics are dilated due to either inflammation or malignant invasion they become visible as v...
- Donna T Geddes
- donna.geddes@uwa.edu.au
- 2009
2010年5月27日 · Postpartum haemorrhage (PPH) is a significant and increasing contributor to maternal mortality and morbidity. Following a PPH, women may have difficulties initiating and sustaining breastfeeding, although little has been published on this issue.
2020年10月28日 · The length of hospital stay of 725 infants from four RCT studies was measured. The meta-analysis did not demonstrate a significant reduction in length of hospital stay in the DHM group compared to the infant formula group (− 0.22 days; 95% CI -6.38, 5.95 days; p = 0.94).
2020年2月24日 · A survey conducted in the central and western regions of China reported a rate of exclusive breastfeeding of 58.3% for newborns (aged 0 to 27 days), which declined to 29.1% at 3–4 months and 13.6% at 5–6 months [ 1 ].
2016年6月18日 · A recent systematic review and meta-analysis revealed that breastfeeding initiation after the first hour of birth doubles the risk of neonatal mortality [ 5 ]. In specific countries, initiating within 1 h reduced deaths by 19 % in Nepal [ 6] and 22 % in Ghana [ 7 ].
2020年3月24日 · Excessive weight loss in newborns is associated with neonatal complications such as jaundice and dehydration, which cause renal failure, thrombosis, hypovolemic shock, and seizures.
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