The Attachments of the Breast to the Chest Wall: A Dissection Study.

BACKGROUND: The anatomical descriptions of the attachments of the female breast to the chest wall vary in their structure, location, and terminology within the published literature. METHODS: A dissection study of the attachments of the breast to the chest wall was conducted on 18 female embalmed breasts in the coronal (n = 15) and sagittal planes (n = 3). RESULTS: Perimeter, posterior wall, and horizontal septum attachments were observed. The perimeter along its entire length was attached to the chest wall. Regional and anatomical variation was observed in this structure and location. Sharp dissection was required to remove it from the chest wall, in contrast to the blunt dissection required to remove the posterior wall and horizontal septum attachments. CONCLUSIONS: The breast attaches to the chest wall along its entire perimeter, posterior wall, and horizontal septum, with the perimeter functioning as the primary anchor of the breast to the chest wall. The structure of the perimeter attachment is both periosteal and fascial and requires sharp dissection to remove it from the chest wall. The fascial structures of the posterior wall and horizontal septum require blunt dissection only. The structure of the perimeter has regional variation, and its location on the chest wall has anatomical variation. Detailed anatomical descriptions and illustrations are supported by photographic evidence of cadaver dissections in two planes. Clinical and anatomical terminology are linked, with clinical implications for medical anatomy education, breast modeling, and breast surgery.

The fibro-adipose structure of the female breast: A dissection study.

A paucity of dissection evidence and quantitative data exists to base anatomical descriptions and illustrations of the fibro-adipose structure of the female breast. The aim of this study was to dissect and provide quantitative data of the fibro-adipose structure of the female breast. The fibro-adipose structure of female embalmed breasts were dissected in the coronal (n = 15) and sagittal planes (n = 3). Quantitative data of breast volume, surface area, fibro-adipose pocket number, size and regional variation were collected. Pearson's correlations were used to investigate pocket number and size with breast volume and surface area. Regional variation in pocket number and size were compared using T tests. Throughout the dissection, photographic evidence was collected to support detailed anatomical descriptions. The mean (SD; range) number of pockets located in the superficial region of the breast was 199 ± 53 (108-306) and the mean pocket surface area was 0.88 ± 0.37 cm2 (0.31-1.97). A strong correlation was found between mean pocket number and breast surface area (r2 = 0.8064) and a very weak correlation between mean individual pocket surface area and breast surface area (r2 = -0.1427; P < 0.01). The pockets located anterior to the corpus mamma were significantly larger and less in number (P < 0.05) than those located posterior. The fibro-adipose structure of the female breast is formed by complex scaffolding, consisting of layers of fibrous tissue pockets embedded with adipose tissue which surrounds the corpus mamma and is firmly attached to the perimeter of the breast. Detailed descriptions are supported by quantitative data and photographic evidence. Clin. Anat. 32:146-155, 2019. © 2019 Wiley Periodicals, Inc.