The American Journal of Surgery
Volume 194, Issue 4 , Pages 433-437 , October 2007

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

Presented at the 8th Annual Meeting of the American Society of Breast Surgeons, Phoenix, AZ, May 2–6, 2007

  • Jennifer E. Rusby, M.D.

      Affiliations

    • Division of Surgical Oncology, Yawkey 9A, Massachusetts General Hospital, Fruit St, Boston, MA 02114, USA
    • ,
  • Elena F. Brachtel, M.D.

      Affiliations

    • Department of Pathology, Warren 2, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA
    • ,
  • Alphonse Taghian, M.D., Ph.D.

      Affiliations

    • Department of Radiation Oncology, Cox 3, Massachusetts General Hospital, Blossom St, Boston, MA 02114, USA
    • ,
  • James S. Michaelson, Ph.D.

      Affiliations

    • Division of Surgical Oncology, Yawkey 9A, Massachusetts General Hospital, Fruit St, Boston, MA 02114, USA
    • ,
  • Frederick C. Koerner, M.D.

      Affiliations

    • Department of Pathology, Warren 2, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA
    • ,
  • Barbara L. Smith, M.D., Ph.D.

      Affiliations

    • Division of Surgical Oncology, Yawkey 9A, Massachusetts General Hospital, Fruit St, Boston, MA 02114, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1-617-724-1074; fax: +1-617-724-1079.

Received 1 May 2007 ,Revised 28 June 2007

References 

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  2. Caruso F, Ferrara M, Castiglione G, et al. Nipple-sparing subcutaneous mastectomy: sixty-six months follow-up. Eur J Surg Oncol. 2006;32:937–940
  3. Crowe JP, Kim JA, Yetman R, et al. Nipple-sparing mastectomy: technique and results of 54 procedures. Arch Surg. 2004;139:148–150
  4. Garcia-Etienne CA, Borgen PI. Update on the indications for nipple-sparing mastectomy. J Support Oncol. 2006;4:225–230
  5. Kissin MW, Kark AE. Nipple preservation during mastectomy. Br J Surg. 1987;74:58–61
  6. Petit JY, Veronesi U, Orecchia R, et al. Nipple-sparing mastectomy in association with intra operative radiotherapy (ELIOT): a new type of mastectomy for breast cancer treatment. Breast Cancer Res Treat. 2006;96:47–51
  7. Psaila A, Pozzi M, Barone Adesi L, et al. Nipple-sparing mastectomy with immediate breast reconstruction: a short term analysis of our experience. J Exp Clin Cancer Res. 2006;25:309–312
  8. Sacchini V, Pinotti JA, Barros AC, et al. Nipple-sparing mastectomy for breast cancer and risk reduction: oncologic or technical problem?. J Am Coll Surg. 2006;203:704–714
  9. Holzgreve W, Beller FK. Surgical complications and follow-up evaluation of 163 patients with subcutaneous mastectomy. Aesthetic Plast Surg. 1987;11:45–48
  10. Aiache A. Surgical repair of the inverted nipple. Ann Plast Surg. 1990;25:457–460
  11. Dixon JM, Thompson AM. Effective surgical treatment for mammary duct fistula. Br J Surg. 1991;78:1185–1186
  12. Srivastava A, Griwan MS, Samaiyar SS, et al. A safe technique of major mammary duct excision. J R Coll Surg Edinburgh. 1995;40:35–37
  13. Going JJ, Moffat DF. Escaping from Flatland: clinical and biological aspects of human mammary duct anatomy in three dimensions. J Pathol. 2004;203:538–544
  14. Rusby JE, Brachtel EF, Michaelson JS, et al. Breast duct anatomy in the human nipple: three-dimensional patterns and clinical implications. Breast Cancer Res Treat [Epub ahead of print: January 13, 2007].
  15. Taneri F, Kurukahvecioglu O, Akyurek N, et al. Microanatomy of milk ducts in the nipple. Eur Surg Res Europaische Chirurg Forsch. 2006;38:545–549
  16. Cooper A. On the Anatomy of the Breast. London: Longman, Orme, Green, Brown-1840.
  17. Nakajima H, Imanishi N, Aiso S. Arterial anatomy of the nipple-areola complex. Plast Reconstruct Surg. 1995;96:843–845
  18. Benediktsson K, Perbeck L. The influence of radiotherapy on skin circulation of the breast after subcutaneous mastectomy and immediate reconstruction. Br J Plast Surg. 1999;52:360–364
  19. Sikand K, Lee AH, Pinder SE, et al. Sections of the nipple and quadrants in mastectomy specimens for carcinoma are of limited value. J Clin Pathol. 2005;58:543–545
  20. Fiala JC. Reconstruct: a free editor for serial section microscopy. J Microsc. 2005;218:52–61
  21. Naccarato AG, Viacava P, Bocci G, et al. Definition of the microvascular pattern of the normal human adult mammary gland. J Anat. 2003;203:599–603
  22. Bosari S, Lee AK, DeLellis RA, et al. Microvessel quantitation and prognosis in invasive breast carcinoma. Hum Pathol. 1992;23:755–761
  23. Komorowski AL, Zanini V, Regolo L, et al. Necrotic complications after nipple- and areola-sparing mastectomy. World J Surg. 2006;30:1410–1413
  24. Barnea Y, Cohen M, Weiss J, et al. Clinical confirmation that the nipple areola complex relies solely on the dermal plexus. Plast Reconstruct Surg. 1998;101:2009–2010
  25. Petit JY, Veronesi U, Orecchia R, et al. The nipple-sparing mastectomy: early results of a feasibility study of a new application of perioperative radiotherapy (ELIOT) in the treatment of breast cancer when mastectomy is indicated. Tumori. 2003;89:288–291
  26. Rusby JE, Kirstein LJ, Brachtel EF, et al. Nipple sparing masectomy: lessons from ex-vivo procedures. 2007;In: Abstract of the 31st Annual Symposium of the American Society of Breast Disease; April 12–14; San Francisco, CA. Abstract T-13.

PII: S0002-9610(07)00538-7

doi: 10.1016/j.amjsurg.2007.06.019

The American Journal of Surgery
Volume 194, Issue 4 , Pages 433-437 , October 2007

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