Hartmann Human Lactation Research Group, School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia, Crawley, Western Australia, Australia.
Clin Anat. 2013 Jan;26(1):29-48. doi: 10.1002/ca.22165. Epub 2012 Sep 19.
Mammary glands are unique to mammals, with the specific function of synthesizing, secreting, and delivering milk to the newborn. Given this function, it is only during a pregnancy/lactation cycle that the gland reaches a mature developmental state via hormonal influences at the cellular level that effect drastic modifications in the micro- and macro-anatomy of the gland, resulting in remodeling of the gland into a milk-secretory organ. Pubertal and post-pubertal development of the breast in females aids in preparing it to assume a functional state during pregnancy and lactation. Remarkably, this organ has the capacity to regress to a resting state upon cessation of lactation, and then undergo the same cycle of expansion and regression again in subsequent pregnancies during reproductive life. This plasticity suggests tight hormonal regulation, which is paramount for the normal function of the gland. This review presents the current status of knowledge of the normal macro- and micro-anatomy of the human mammary gland and the distinct changes it undergoes during the key developmental stages that characterize it, from embryonic life through to post-menopausal age. In addition, it discusses recent advances in our understanding of the normal function of the breast during lactation, with special reference to breastmilk, its composition, and how it can be utilized as a tool to advance knowledge on normal and aberrant breast development and function. Finally, anatomical and molecular traits associated with aberrant expansion of the breast are discussed to set the basis for future comparisons that may illuminate the origin of breast cancer.
乳腺是哺乳动物所特有的,其具有合成、分泌和向新生儿输送乳汁的特定功能。鉴于此功能,只有在怀孕/哺乳期,乳腺才会在细胞水平的激素影响下达到成熟的发育状态,从而导致乳腺的微观和宏观解剖结构发生剧烈变化,使乳腺重塑为一个分泌乳汁的器官。女性青春期和哺乳期后的乳房发育有助于其在怀孕期间和哺乳期做好功能准备。值得注意的是,该器官在停止哺乳后会退化到静止状态,然后在生殖期的后续怀孕中再次经历同样的扩张和退化周期。这种可塑性表明存在严格的激素调节,这对于乳腺的正常功能至关重要。本综述介绍了人类乳腺正常的宏观和微观解剖结构的最新知识,以及其在胚胎期到绝经后期间的关键发育阶段所经历的显著变化。此外,还讨论了我们对哺乳期乳腺正常功能的最新理解,特别提到了母乳、其组成以及如何利用母乳作为工具来推进对正常和异常乳腺发育和功能的认识。最后,讨论了与乳腺异常扩张相关的解剖和分子特征,为未来的比较奠定了基础,这些比较可能阐明乳腺癌的起源。