Is the statement that the breast is a modified holocrine gland, the axillary tail is always present, the superficial fascia is the upward continuation of Scarpa's (fascia of the abdomen) fascia, the submammary space is between the superficial fascia and the pectoralis fascia, and there are about 45 major ducts that open separately into the nipple true or false?

Breast Anatomy: Statement Evaluation

Most of these statements are FALSE, with only statement D being accurate regarding the submammary space location.

Statement-by-Statement Analysis

A. The breast is a modified holocrine gland - FALSE

• The breast is a modified apocrine gland, not a holocrine gland 1
• Holocrine glands (like sebaceous glands) release entire cells as secretion, whereas mammary glands secrete milk through apocrine mechanisms without complete cellular destruction 1
• The mammary gland develops from the epidermis and undergoes complex developmental stages from gestation through lactation 1

B. The axillary tail is always present - FALSE

• The axillary tail (tail of Spence) is not always present in all individuals 2
• When present, it represents a continuation of breast tissue from the upper lateral quadrant that extends into the axilla through the foramen of Langer in the deep fascia 2
• Clinical recognition is important as lesions in this area can be challenging to diagnose, requiring differentiation from axillary lymph nodes 3

C. The superficial fascia is the upward continuation of Scarpa's fascia - TRUE

• Recent anatomical studies confirm that Scarpa's fascia does contribute to breast structure 4
• Scarpa's fascia forms both the anterior and posterior lamellae of the breast pocket, creating a circummammary ligament that stabilizes the breast against the thoracic wall 4
• This represents a reinterpretation of traditional breast anatomy, showing that major fasciae of the anterior body wall, including both Camper's and Scarpa's fascia, contribute to breast structure 4

D. The submammary space is between the superficial fascia and pectoralis fascia - TRUE

• The submammary space (retromammary space) is correctly described as lying between the posterior aspect of the breast tissue and the pectoralis fascia 5, 6
• The superficial pectoral fascia can be easily separated and undermined during surgical procedures, confirming this anatomical plane 6
• This space is clinically relevant for breast augmentation and other surgical procedures 5, 6

E. There are about 45 major ducts opening in the nipple - FALSE

• The breast has approximately 15-20 major lactiferous ducts that open separately at the nipple, not 45 1
• These ducts form during fetal development (6-20 weeks gestation) and continue to develop through puberty and pregnancy 1
• The ductal system undergoes significant branching and terminal end bud formation during pubertal development 1

Clinical Relevance

Key anatomical considerations:

• Understanding the fascial layers is critical for surgical planning, particularly in breast augmentation where the subfascial plane must be properly identified 6
• The clavipectoral fascia serves as the anatomical boundary between breast parenchyma and axillary structures 3
• Proper identification of the axillary tail when present is essential to avoid misdiagnosis of breast lesions as lymph node metastases 2, 3