{"title":"Duplex Study of the Nipple-Areola Complex Blood Supply in the Female Breast.","authors":"Husam Hosny, Sahar Mansour, Nadeen M El-Essawy","doi":"10.1093/asjof/ojae090","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although breast blood supply comes from the internal mammary, lateral thoracic, and intercostal artery perforators, the nipple-areola complex (NAC) blood supply was usually depicted as a direct continuation of those vessels rather than a true description based on anatomical research. Studies focusing on NAC vascularity are few in number, done on a limited number of subject based on microdissection, computed tomography, or MRI. The results are inconsistent and may be perplexing. Hence, the need for studies on a large number of living subject is still warranted. Because duplex proved efficient at detecting perforators, we used it to assess NAC vascularity.</p><p><strong>Objectives: </strong>In vivo delineation of NAC blood supply by comparing this to the nipple-to-suprasternal notch (N-SN) distance and individual variation between both sides.</p><p><strong>Methods: </strong>Female subject presenting to the Breast Imaging Unit of the institute (229 subject; 458 breasts, BIRADS I and II) were assessed by duplex for the presence of significant NAC blood supply (≥1 mm), regarding their number, source vessel, perforator level, relation to N-SN distance, and similarity between both sides.</p><p><strong>Results: </strong>The third and fourth internal mammary artery (IMA) perforators accounted for 54.8% and 31.3%, respectively. The second IMA, lateral thoracic artery, and direct axillary branch were found in 9.2%, 3.3%, and 1.3%, respectively. The longer the N-SN distance is, the lower the supplying perforator. NAC vascularity was symmetric in 143 subject (62.4%) and asymmetric in 86 subject (37.5%).</p><p><strong>Conclusions: </strong>The third and fourth internal mammary perforators are the main source of NAC blood supply. Right and left sides' asymmetry is not uncommon. Finally, the longer the N-SN distance is, the lower the perforator level is anticipated.</p><p><strong>Level of evidence 1 diagnostic: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"7 ","pages":"ojae090"},"PeriodicalIF":1.9000,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11997777/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aesthetic surgery journal. Open forum","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/asjof/ojae090","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Although breast blood supply comes from the internal mammary, lateral thoracic, and intercostal artery perforators, the nipple-areola complex (NAC) blood supply was usually depicted as a direct continuation of those vessels rather than a true description based on anatomical research. Studies focusing on NAC vascularity are few in number, done on a limited number of subject based on microdissection, computed tomography, or MRI. The results are inconsistent and may be perplexing. Hence, the need for studies on a large number of living subject is still warranted. Because duplex proved efficient at detecting perforators, we used it to assess NAC vascularity.
Objectives: In vivo delineation of NAC blood supply by comparing this to the nipple-to-suprasternal notch (N-SN) distance and individual variation between both sides.
Methods: Female subject presenting to the Breast Imaging Unit of the institute (229 subject; 458 breasts, BIRADS I and II) were assessed by duplex for the presence of significant NAC blood supply (≥1 mm), regarding their number, source vessel, perforator level, relation to N-SN distance, and similarity between both sides.
Results: The third and fourth internal mammary artery (IMA) perforators accounted for 54.8% and 31.3%, respectively. The second IMA, lateral thoracic artery, and direct axillary branch were found in 9.2%, 3.3%, and 1.3%, respectively. The longer the N-SN distance is, the lower the supplying perforator. NAC vascularity was symmetric in 143 subject (62.4%) and asymmetric in 86 subject (37.5%).
Conclusions: The third and fourth internal mammary perforators are the main source of NAC blood supply. Right and left sides' asymmetry is not uncommon. Finally, the longer the N-SN distance is, the lower the perforator level is anticipated.