Cooper's ligaments (also known as the suspensory ligaments of Cooper and the fibrocollagenous septa) are

connective tissue Connective tissue is one of the four primary types of animal tissue, a group of cells that are similar in structure, along with epithelial tissue, muscle tissue, and nervous tissue. It develops mostly from the mesenchyme, derived from the mesod ...

in the

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 embryology, embryological tissues. The relative size and development of the breasts is ...

that help maintain structural integrity. They are named for

Astley Cooper Sir Astley Paston Cooper, 1st Baronet (23 August 176812 February 1841) was a British surgeon and anatomist, who made contributions to otology, vascular surgery, the anatomy and pathology of the mammary glands and testicles, and the pathology ...

, who first described them in 1840. Their anatomy can be revealed using transmission diffraction tomography. Cooper's suspensory ligament should not be confused with the pectineal ligament (sometimes called the inguinal ligament of Cooper) which shares the same

eponym An eponym is a noun after which or for which someone or something is, or is believed to be, named. Adjectives derived from the word ''eponym'' include ''eponymous'' and ''eponymic''. Eponyms are commonly used for time periods, places, innovati ...

. Also, the intermediate fibers and/or the transverse part of the ulnar collateral ligament are sometimes called Cooper's ligament(s).

Structure

The ligaments run from the

clavicle The clavicle, collarbone, or keybone is a slender, S-shaped long bone approximately long that serves as a strut between the scapula, shoulder blade and the sternum (breastbone). There are two clavicles, one on each side of the body. The clavic ...

and the clavipectoral fascia, branching out through and around breast tissue to the dermis of the skin overlying the breast. The intact ligament suspends the breast from the clavicle and the underlying deep fascia of the upper chest. This has the effect of supporting the breast in its normal position, and maintaining its normal shape. Without the internal support of this ligament, the breast tissue (which is heavier than the surrounding fat) sags under its own weight, losing its normal shape and contour.

Clinical significance

The suspensory ligaments of Cooper play an important role in the change in appearance of the breast that often accompanies the development of inflammatory carcinoma of the breast in which blockage of the local lymphatic ducts causes swelling of the breast. Because the skin remains tethered by the suspensory ligaments of Cooper, it takes on a dimpled appearance reminiscent of the peel of an orange ( peau d'orange). Carcinomas can also decrease the length of Cooper's ligaments leading to a dimpling.

Relationship to sagging

Many women believe that sagging (ptosis) is caused by the failure of the Cooper's ligaments to support the breast tissue. In fact, ptosis is partly determined by genetic factors, but a review found that the biggest factors are higher

body mass index Body mass index (BMI) is a value derived from the mass (Mass versus weight, weight) and height of a person. The BMI is defined as the human body weight, body mass divided by the square (algebra), square of the human height, body height, and is ...

, larger breast size, significant weight loss, smoking, her number of pregnancies, and her age. Many women incorrectly believe that wearing a

brassiere A bra, short for brassiere or brassière (, ; ), is a type of form-fitting underwear that is primarily used to support and cover a woman's breasts. A typical bra consists of a chest band that wraps around the torso, supporting two breast cu ...

prevents their breasts from sagging later in life and that breasts cannot anatomically support themselves. But bra manufacturers have stated that because breasts are formed of fatty tissue and not muscle, bras only affect the shape of breasts while they are being worn. Pathologically heavy breasts may cause pain in the woman's upper thoracic area, but this may be due to a poorly-fitting bra. Numerous reports state that 80–85% of women are wearing the wrong bra size. In middle-aged women, breast ptosis is caused by a combination of factors. If the woman has had children, postpartum

hormonal A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs or tissues by complex biological processes to regulate physiology and behavior. Hormones a ...

changes will cause the depleted milk glands to atrophy. Women who experience multiple pregnancies repeatedly stretch the skin envelope during engorgement while

lactating Lactation describes the secretion of milk from the mammary glands and the period of time that a mother lactates to feed her young. The process naturally occurs with all sexually mature female mammals, although it may predate mammals. The proces ...

. As a woman's breasts grow in size during repeated pregnancies, the Cooper's ligaments that maintain the position of the

mammary gland A mammary gland is an exocrine gland that produces milk in humans and other mammals. Mammals get their name from the Latin word ''mamma'', "breast". The mammary glands are arranged in organs such as the breasts in primates (for example, human ...

s against the chest are stretched and gradually lose strength. Breast tissue and suspensory ligaments may also be stretched if the woman is overweight or loses and gains weight.

References

{{DEFAULTSORT:Cooper's Ligaments Breast anatomy Ligaments