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. 2007 Oct;194(4):433-7.
doi: 10.1016/j.amjsurg.2007.06.019.

George Peters Award. Microscopic anatomy within the nipple: implications for nipple-sparing mastectomy

Jennifer E Rusby  1 , Elena F Brachtel, Alphonse Taghian, James S Michaelson, Frederick C Koerner, Barbara L Smith
Affiliations

George Peters Award. Microscopic anatomy within the nipple: implications for nipple-sparing mastectomy

Jennifer E Rusby et al. Am J Surg. 2007 Oct.

Abstract

Background: 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.

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