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Review
. 2015 Dec;4(6):476-83.
doi: 10.3978/j.issn.2227-684X.2015.02.06.

Anatomy relevant to conservative mastectomy

Rachel L O'Connell  1 , Jennifer E Rusby  1
Affiliations
Review

Anatomy relevant to conservative mastectomy

Rachel L O'Connell et al. Gland Surg. 2015 Dec.

Abstract

Knowledge of the anatomy of the nipple and breast skin is fundamental to any surgeon practicing conservative mastectomies. In this paper, the relevant clinical anatomy will be described, mainly focusing on the anatomy of the "oncoplastic plane", the ducts and the vasculature. We will also cover more briefly the nerve supply and the arrangement of smooth muscle of the nipple. Finally the lymphatic drainage of the nipple and areola will be described. An appreciation of the relevant anatomy, together with meticulous surgical technique may minimise local recurrence and ischaemic complications.

Keywords: Anatomy; conservative mastectomy; nipple; nipple-sparing.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Operative image to show the “oncoplastic plane” with white connective tissue between subcutaneous fat and parenchymal fat shown by black arrows.
Figure 2
Figure 2
Three-dimensional reconstruction of a nipple. Skin in tan, cut edge in yellow and ducts in purple. Reproduced with permission from ref (12).
Figure 3
Figure 3
Coronal section of a nipple with nipple outline, duct bundle and peripheral 2 and 3 mm rims marked. Vessels stained with anti-factor VIII antibody to vascular endothelium have been highlighted and counted. Ducts are faintly visible within the central duct bundle. In this example, leaving either a 2 or 3 mm rim would have removed all ductal tissue. Reproduced with permission from ref (29).
Figure 4
Figure 4
Section with muscle fibres. Circular fibres highlighted in blue, longitudinal fibres in orange. Reproduced with permission from ref (40).
See this image and copyright information in PMC

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