Approaches of application anatomy of innervation in nipple and areola of breast

Xiang LI; Fengchun LIU

ABSTRACT

BACKGROUND:

During plasty of breast, innervation in nipple and areola of breast should be comprehended particularly in order to avoid sensory and motor disorder induced by nerve injury.

OBJECTIVE:

To observe the courser and distribution of nerve in nipple and areola of breast and provide anatomic data for plasty of breast.

DESIGN:

Single sampling study.

SETTING:

Department of Human Anatomy, Medical College of Qingdao University; Department of Pathology, Affiliated Hospital of Medical College of Qingdao University.

PARTICIPANTS:

The experiment was carried out in the Department of Human Anatomy, Medical College of Qingdao University and Department of Pathology, Affiliated Hospital of Medical College of Qingdao University from September 1999 to April 2001. Sixteen breasts of 8 adult female corpses aged 20-40 years and 10 breasts (5 right and 5 left) of 10 adult females with cancer of the breast aged 43-58 years were selected in this study. All patients or relations were consent.

METHODS:

① Breast samples of 16 adult female corpses were scanned layers by layers with stereo anatomic micro scope to chase courser and distribution of nerve in subcutaneous fascia of mammary cancer. ② Ten fresh breast sam pies were frozen, cut into sections and stained with haematine-eosin. The typical transects were selected to observe dis tributed density of nerve fiber in 4 quadrants at various layers with stereology. MAIN OUTCOME

MEASURES:

① Innervation in nipple and areola of breast,, ② numbers of nerve fiber of the same sample in various transects.

RESULTS:

① Nerve which was distributed in nipple and areola of breast was derived from the lateral cutaneous branch and anterior cutaneous branch of the 3rd, 4th and 5th intercostal nerves and deep branch of mammary cancer. ② The lat eral cutaneous branch of the 4th intercostal nerves went into nipple and areola of breast with the directions like 4 o'clock in the left and 8 o'clock in the right, and nerves dominated nipple were derived from the lateral cutaneous branch of the 4th intercostal nerves. ③ Numbers of nerve fiber in extra-inferior quadrant of nipple and areola of breast were more than those in intra-superior, intra-inferior and extra-superior quadrants (8.06±0.18, 4.63±0.14, 4.43±0.16, 2.13±0.11, P ＜ 0.01). ④ Density of innervation in nipple and areola of breast was decreased centripetally.

CONCLUSION:

Operation of chest, especially plasty of breast, had better not damage lateral cutaneous branch and ante rior cutaneous branch of the 3rd, 4th and 5th intercostal nerves. Extraordinarily, the lateral cutaneous branch of the 4th inter costal nerves and nerve in extra-inferior quadrant of nipple and areola of breast should be protected carefully in order to avoid sensory disorder.