[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Chest · Female](https://durgical.com/en/anatomy/region/chest/) › Suspensory ligaments of breast [Skin](https://durgical.com/en/anatomy/system/skin/) · [Chest · Female](https://durgical.com/en/anatomy/region/chest/) # Suspensory ligaments of breast The suspensory ligaments of the breast (Cooper's ligaments) are fibrous bands that support the breast; a cancer pulling on them dimples the skin. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=thorax&variant=female&select=suspensory_ligaments_breast&side=r) Opens in the Durgical app, no sign-up needed. ## What it is Fibrous bands (Cooper's ligaments) that run through the breast from the fascia over the pectoralis major to the skin. ## What it does Hold up the breast and divide it into compartments. They stretch with age, weight changes and pregnancy, so the breast hangs lower (ptosis). ## Key points - Skin dimpling over a lump means a tumour is pulling on these ligaments, even when the lump itself is small - Peau d'orange (orange-peel skin) comes from blocked dermal lymphatics: the swollen skin bulges between pores still tethered to it; it is a hallmark of inflammatory breast cancer - They divide the breast into compartments, which shapes how abscesses and fluid collect ## Key facts **Attaches** Dermis of the breast skin through the gland to the pectoral fascia **Function** Support the breast (Cooper's ligaments); tumour traction on them causes skin dimpling (retraction) ## Relations **Course** From the [pectoral fascia](https://durgical.com/en/anatomy/pectoral-fascia/) over the [pectoralis major](https://durgical.com/en/anatomy/pectoralis-major-muscle/), through the fat and between the lobes, to the dermis of the [skin](https://durgical.com/en/anatomy/skin/) **Deep** Pectoral fascia, across the retromammary space **Superficial** Dermis of the breast skin, where they anchor ## How to find it Not felt as separate bands. In a dissection, or when skin flaps are raised in a mastectomy, they appear as fibrous strands running up from the tissue over the lobes into the dermis, dividing the fat into compartments; they have to be cut to free the skin. ## Examination - Inspection with the arms raised and with the hands pressed on the hips: a dimple or a flattened contour appears as the ligaments are put under tension - Gently lifting or moulding the breast around a lump: puckering of the skin above it shows tethering ## On imaging On ultrasound and mammography they are thin curved lines between the fat lobules; thickened, straightened or retracted ligaments near a mass suggest infiltration, and architectural distortion is a recognized mammographic sign of cancer. ## Common problems - A cancer that pulls on these ligaments draws the skin in: a dimple (skin retraction), a warning sign. - Stretched ligaments: a sagging breast (ptosis). ## How it is diagnosed Looking at the breasts with the arms raised shows a dimple; mammography and ultrasound look for a mass beneath it. ## Treatment - Ptosis: a supportive bra, or a breast lift (mastopexy). - A dimple from a cancer is treated with the cancer. ## Clinical notes - Breast ptosis is graded by where the [nipple](https://durgical.com/en/anatomy/nipple/) sits relative to the inframammary fold - Inflammatory breast cancer causes redness, warmth and peau d'orange over much of the breast and can be mistaken for mastitis - The same skin dimpling can follow fat necrosis or surgery, which is why imaging and biopsy decide the cause ## Related conditions - [Breast cancer](https://durgical.com/en/conditions/breast-cancer/) - [Breast fibroadenoma](https://durgical.com/en/conditions/breast-fibroadenoma/) - [Fibrocystic breast changes](https://durgical.com/en/conditions/fibrocystic-breast-changes/) ## Test yourself Think of the answer, then tap the question to see it. ## What does skin dimpling over a breast lump mean? A tumour is pulling on the suspensory ligaments (Cooper), even when the lump itself is small. ## What causes peau d'orange, and which cancer is it a hallmark of? Blocked dermal lymphatics: swollen skin bulges between pores still tethered to it; a hallmark of inflammatory breast cancer. ## Where do the suspensory ligaments of the breast attach? From the pectoral fascia over the pectoralis major, through the gland and fat, to the dermis of the breast skin. ## How is a subtle dimple from suspensory ligament tethering brought out on inspection? With the arms raised and with the hands pressed on the hips, which puts the ligaments under tension. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/suspensory-ligaments-of-breast/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** ligamenta suspensoria mammaria TA2 7109 **Official Spanish (DeCS)** Ligamentos suspensorios de la mama **English (TA2)** Suspensory ligaments of breast **Also called** suspensory retinaculum of breast · ligamenta suspensoria mammae · cooper’s ligaments Sources: Terminologia Anatomica (TA2); [Anatomy, Thorax, Breast](https://www.ncbi.nlm.nih.gov/books/NBK519575/); [Anatomy, Thorax: Mammary Gland](https://www.ncbi.nlm.nih.gov/books/NBK547666/); [27.2 Anatomy and Physiology of the Ovarian Reproductive System](https://openstax.org/books/anatomy-and-physiology-2e/pages/27-2-anatomy-and-physiology-of-the-ovarian-reproductive-system) (OpenStax (Rice University), 2022) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/suspensory-ligaments-of-breast/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/suspensory-ligaments-of-breast/