The most important factor for breast augmentation is to dissect the accurate size of implantation pockets. This study was performed to investigate the anatomical association of the pectoralis major muscle(PMM) with the female breast shape for improving the success rate of mammoplasty. This study included 60 women(120 breasts) in their twenties to thirties who were imaged by CT between September 2006 and December 2007. On reconstructed 3D CT images, 6 points in the area of the PMM were selected as fiducial points, and the PMM contour and the correlation of the PMM with the nipple were analyzed using the imaginary lines connecting individual points. As the volume increased, the lateral and inferior borders of the PMM moved to the superomedial side from the nipple. As the ptosis degree increased, the density became lower, and the lateral and inferior borders of the PMM moved to the superomedial side of the nipple. However, there was no significant correlation between age and PMM contour. The results of this study suggest that the PMM contour may change according to the volume, ptosis and density of the breast. This study can provide objective information for breast surgery, thereby increasing the success rate of mammoplasty.
Anatomy, Regional ; Breast ; Female ; Humans ; Mammaplasty ; Nipples ; Pectoralis Muscles

The purpose of this study was to evaluate the thickness of the compressed breast in mediolateral oblique (MLO) and craniocaudal (CC) mammograms, to relate these thickness and breast patterns to mean glandular dose (MGD) in Korean women, and to evaluate the suitability of using the American College of Radiology's Recommendations for Korean women from a quality assurance standpoint. The study population consisted of 92 paired MLO and CC mammograms obtained on one mammographic unit. The digital readouts of compressed breast thickness, applied compression force and tube voltage were recorded. Entrance skin exposure was measured by dosimetry. MGD was calculated by multiplying entrance skin exposure by the exposure-to-absorbed dose conversion factor. The range of breast thickness was 1.3 - 6.2 cm in CC mammograms with a mean breast thickness of 3.6 cm, and 1.6 - 6.5 cm in MLO mammograms with a mean breast thickness of 3.9 cm. MGDs in CC and MLO mammograms were 1.77 mSv and 1.88 mSv per view, respectively. Breast composition patterns were divided into 4 groups according to ACR BI-RADS; P1 (n=20), P2 (n=16), P3 (n=48) and P4 (n=8). The MGDs for these groups were: 1.82, 1.84, 1.84, and 1.91 mSv, respectively. When subjects were subdivided by breast thickness into three groups, namely, below 3 cm, 3 cm to 4.2 cm, aaa and above 4.2 cm, the corresponding MGDs were 1.83, 1.86, and 1.91 mSv. According to our initial trial, the mean breast thickness and the MGDs of Korean women are lower than recommended by the American College of Radiology, which are commonly used for quality assurance purposes.
Adult ; Breast/anatomy & histology ; Female ; Human ; *Mammography ; Middle Aged ; *Radiation Dosage

OBJECTIVETo measure breast basic dimension by using computer-aided projection fringe system.

METHODSA system has been developed for measuring breast basic dimension based on computer-aided projection fringe measurement and programming software. Plastic manikins breast's SN-N (sternal notch to nipple distance), N-ML (nipple to midline distance), N-N (internipple distance), MBW (base width of breast) and N-IMF (nipple to inframammary fold distance) are measured with this system. At the same time, these items are also measured with routine ruler.

RESULTSThis study indicate that the system has some merits: (1) non-touching measurement; (2) it is very rapid, the patient measured need hold his breath only 0.5 second, and all the time it takes is about 2.5 minutes; (3) the measurement's sensitivity is as high as to 0.6 mm, which meets the clinic requirement entirely; (4) the measurement's accuracy of the system is not significantly when comparing to the routine ruler's.

CONCLUSIONSComputer-aided projection fringe system for measuring breast basic dimension is feasible and advanced.

Breast ; anatomy & histology ; Female ; Humans ; Image Processing, Computer-Assisted ; Tomography, Optical ; methods

OBJECTIVETo establish a standard method for digital evaluation of breast symmetry with 3D scanning technique.

METHODSFrom January 2009 to July 2010, 167 patients received 3D scanning before breast augmentation. The coordinate system was established and the 3D reconstructed breast models were analyzed by software. The discrepancy of nipple level, the distance between nipple to midline, inferior mammary fold location, breast width, breast projection, breast volume and anterior chest wall projection were measured.

RESULTSThe mean discrepancy of nipple level, the distance between nipple to midline, IMF level, breast width, breast projection and anterior chest wall projection were (4. 8 +/- 3.9) mm, (4.5 +/- 3.4) mm, (4.6 +/- 3.7) mm, (4.8 +/- 2.9) mm, (5.4 +/- 3.9) mm and (4.8 +/- 3.3) mm, respectively. The mean difference of breast volume was (51 +/- 44) ml. The incidence of significant asymmetry was 73% (122/167)in nipple position, 95% (159/167)in breast shape, 38% (63/167)in anterior chest wall projection.

CONCLUSIONS3D scanning technique can provide an accurate 3D measurement of breast. A thorough and objective evaluation of breast symmetry can be achieved.

Adult ; Breast ; anatomy & histology ; Female ; Humans ; Imaging, Three-Dimensional ; Mammaplasty ; Middle Aged ; Software ; Young Adult

OBJECTIVEto investigate the pattern of the blood supply and the nerve distribution of breast, in order to find a way for short-scar reduction mammaplasty.

METHODSTwelve adult women cadavers were investigated for the vascularture of the anterior thorax and the nerve distribution of the breasts by using the blood vessel casting, specimen transparency technique and the autopsy. Based on the anatomical study, a modified double-circle reduction mammaplasty technique was designed to treat 28 patients with hypertrophical breasts.

RESULTSThere existed two- or three-layers vasculature in the anterior thorax. The extensive vertical vascular anastomoses were found among the three layers. The cutaneous perforators, penetrated out of the pectoralis major muscle, were formed a dense vessel network in the retromammary space. The vertical vessels thereafter emerged from the network, passed through gland and linked to the subcutaneous vessels. These vertical vessels were smaller and denser above the fourth intercostal space, but they were larger and sparser below the fourth intercostal space. The innervation of the nipple-areola mainly came from the lateral deep branches of the 4th intercostal nerve. It appeared S-shape running into the dropped breasts. The 28 patients were successfully treated with the modified technique, except one case with the loss of the nipple-areola sense.

CONCLUSIONThe modified double-circle reduction mammaplasty could maximally fulfill the blood supply to the remained gland and the innervations to the nipple-areola, by keeping the advantages of the traditional technique such as invisible scar, good projection and the long lasting results. It could also be a safe and reliable technique.

Adolescent ; Adult ; Aged ; Blood Vessels ; anatomy & histology ; Breast ; blood supply ; innervation ; surgery ; Cadaver ; Female ; Humans ; Mammaplasty ; methods ; Models, Anatomic ; Nervous System ; anatomy & histology ; Treatment Outcome

BACKGROUND: Lower abdominal soft tissue transfer is the standard procedure for breast reconstruction. However, abdominal wall weakness and herniation commonly occur postoperatively at the donor site. To reduce the morbidities of the donor site, the superficial inferior epigastric artery (SIEA) flap was introduced, but inconsistent anatomy of the SIEA has reduced its utility. In the present study, the anatomy of the superficial inferior epigastric vessels in Korean women was determined with regards to breast reconstructive surgery. METHODS: The vascular anatomies of the SIEA and superficial inferior epigastric vein (SIEV) were evaluated on 32 breast cancer patients receiving free transverse rectus abdominis musculocutaneous flap reconstruction after mastectomy. The existence, pulsation, location, external diameter, and depth of the SIEA and SIEV were measured at the lower abdominal incision level. RESULTS: SIEA and SIEV were present in 48/64 (75.00%) and 63/64 (98.44%) hemi-abdomens, respectively. Pulsation of the SIEA was found in 44/48 (91.67%) cases. The mean locations of SIEA and SIEV were +5.79 (+/-12.87) mm, and -8.14 (+/-15.24) mm from the midpoint between the anterior superior iliac spine and symphysis pubis, respectively. The mean external diameters of SIEA and SIEV were 1.20 (+/-0.39) mm and 1.37 (+/-0.33) mm, and they were found at a mean depth of 9.75 (+/-2.67) mm and 8.33 (+/-2.65) mm, respectively. CONCLUSIONS: The SIEA was absent in 25% of Korean women and had a relatively small caliber. Therefore, careful preoperative assessment of the lower abdominal vasculature is required to achieve successful breast reconstruction using SIEA flaps.
Abdominal Wall ; Anatomy, Regional ; Asian Continental Ancestry Group ; Breast ; Breast Neoplasms ; Epigastric Arteries* ; Female ; Humans ; Mammaplasty ; Mastectomy ; Myocutaneous Flap ; Rectus Abdominis ; Spine ; Tissue Donors ; Veins

OBJECTIVETo assess the effect of different schemes of premenopausal tamoxifen therapy on the endometrium.

METHODSTotally 109 normal premenopausal women positive for high-risk factors of breast cancer were divided into two groups, namely periodic and consecutive tamoxifen treatment groups. Endometrial thickness as examined by vaginal sonography was assessed in relation to duration of tamoxifen use and time from discontinuation of the drug.

RESULTSAfter one year of tamoxifen use, the mean endometrial thickness in periodic treatment group was 6.5-/+1.4 mm, and 10.2-/+2.0 mm in consecutive treatment group. Endometrial thickness increased with the duration of tamoxifen use at the rate of 0.51 mm/year in the periodic treatment group, and 0.73 mm/year in consecutive treatment group. After discontinuation of tamoxifen, the endometrial thickness in the former group decreased by 1.29 mm/year, and by 1.33 mm/year in the latter.

CONCLUSIONSEndometrial hyperplasia is obviously milder in premenopausal women receiving periodic tamoxifen treatment who are at risk for breast cancer than that in women with consecutive treatment. After discontinuation of the drug, the endometrial thickness decreases at a roughly equal slow rate in the two groups.

Adult ; Breast Neoplasms ; drug therapy ; Drug Administration Schedule ; Endometrium ; anatomy & histology ; diagnostic imaging ; drug effects ; Female ; Humans ; Premenopause ; drug effects ; Risk ; Tamoxifen ; administration & dosage ; pharmacology ; therapeutic use ; Time Factors ; Ultrasonography