Analysis of nipple-areola blood supply in patients with breast hypertrophy and normal population
10.3760/cma.j.issn.1009-4598.2018.02.004
- VernacularTitle: 乳房肥大患者与正常人群乳头乳晕血供研究分析
- Author:
Hui ZHENG
1
;
Yingjun SU
;
Zhaoxiang ZHANG
;
Jian GENG
;
Minwen ZHENG
;
Bei E
;
Jian LI
;
Yi YANG
;
Chenggang YI
;
Xianjie MA
Author Information
1. Department of Plastic and Reconstructive Surgery and Imaging Department, Xijing Hospital, Fourth Military Medical University, Xi′an 710032, China
- Publication Type:Clinical Trail
- Keywords:
Nipple-areola complex;
Blood supply;
Hypertrophy;
Computed tomography angiography
- From:
Chinese Journal of Plastic Surgery
2018;34(2):92-97
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the nipple-areola complex blood supply mode in hypertrophic breasts, and to obtain the pertinent knowledge of vascular anatomy for breast reduction surgery as well as the analysis of similarities and differences between hypertrophic and normal breasts. Comparing the blood supply of nipples-areola complex between these two groups for analyzing their similarities and differences.
Methods:Three dimensional reconstruction of the arteries in breast were performed in 50 patients between September 2015 and August 2017 with breast hypertrophy by computed tomographic angiography (CT angiography). The distribution pattern and the source direction of each main blood vessel was observed, counted and analyzed. Then, the data of breast hypertrophy patients were compared with the previous data about nipple-areola blood supply in normal population (the definition of main vessel: entering the breast gland or reaching the nipple-areola surrounding area, and diameter larger than 1 mm). Statistical description was taken for comparison.
Results:135 main vessels were observed in 100 breasts (50 patients). They mainly originate from the internal thoracic artery (69, 51.1%), lateral thoracic artery (37, 27.4%) and thoracoacromial artery(16, 11.9%), as well as a small amount from the brachial artery (7, 5.2%) and axillary artery(6, 4.4%). No main supply vessels from the posterior intercostal artery have been found. The patterns of breast blood supply varied among individuals, and high asymmetry ratio in the same individual was also observed. The internal superior (left: 30.7%, right: 34.2%) and superior lateral quadrant (Left: 29.2%, Right: 20%) of the breast was the most likely area for the main vessel to pass, followed by the breast lateral (Left: 16.9%, Right: 18.5%), lower inner (Left: 4.6%, Right: 5.7%), central (Left: 4.6%, Right: 4.2%), and superior (Left: 1.5%, Right: 2.8%). Differences existed in main vessels between normal breasts and hypertrophic breasts, either for source arteries or the distribution of breast. There was no main blood supply from the intercostal arteries or across the outer inferior quadrant.
Conclusions:The blood supply of the nipple-areola is not completely consistent between the hypertrophic breast and the normal size breast, and the blood supply pattern of the hypertrophic breasts is complex and diverse. CT angiography might be used before breast reduction surgery for clarifying the direction of the main vessels, so as to preserve more blood supply for nipple-areola, and to prevent nipple-areola necrosis.
