A carcinoma of the breast produces tethering and dimpling of the overlying skin. Shortening of which anatomical structure directly accounts for this sign?

• A Anterior lamella of the superficial fascia
• B Clavipectoral fascia
• C Suspensory ligaments of Cooper ✓
• D Fascia over pectoralis major

Explanation

The suspensory ligaments of Cooper run from the dermis through breast parenchyma to attach to the pectoral fascia. When tumour cells infiltrate these strands they contract, pulling skin inward to produce dimpling and tethering. Involvement of the deep pectoral fascia instead produces fixation of the lump to muscle tested by tensing pectoralis major, and obstruction of dermal lymphatics produces peau d'orange rather than focal dimpling.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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