Microscopic anatomy within the nipple: implications for nipple-sparing mastectomy

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• 作者：Jennifer E. Rusby ; Elena F. Brachtel ; Alphonse Taghian ; James S. Michaelson ; Frederick C. Koerner ; Barbara L. Smith
• 关键词：Anatomy ; Duct ; Microvessel density ; Nipple-sparing mastectomy
• 刊名：The American Journal of Surgery
• 出版年：2007
• 期刊代码：9_00029610
• 类别：med
• 出版时间：October 2007
• 卷：194
• 期：4
• 页码：433-437
• 文件大小：657 K

摘要

Precise anatomical relationships between ducts and vasculature within the nipple remain unknown. This study investigated nipple microvessels and their position relative to ducts.

Methods

Nipple and duct bundle cross-sectional areas were measured in 48 specimens. Vessels located within the central duct bundle or within a peripheral rim were counted in 7 non-irradiated and 5 irradiated nipples.

Results

Mean nipple diameter was 11.1 mm and duct bundle diameter 5.2 mm. A 2-mm and a 3-mm peripheral rim of nipple tissue would result in complete duct excision in 96%and 87%of sections, respectively. Twenty-nine percent of vessels are located in the duct bundle. A 2-mm rim contains 50%; a 3-mm rim contains 66%. Similar proportions were seen in irradiated nipples.

Conclusions

This study describes a strategy to balance duct removal with vascular preservation. Ducts can be excised leaving a rim of nipple tissue that contains a large proportion of microvessels.