Tumors of female reproductive systemTumors of female reproductive systemОпухоли женской репродуктивной системы1994-40981999-8627Publishing House ABV Press54110.17650/1994-4098-2017-13-2-42-46MAMMOLOGY. REVIEWSМАММОЛОГИЯ. ОБЗОРНЫЕ СТАТЬИTHE BLOOD SUPPLY TO THE NIPPLE-AREOLAR COMPLEX (A LITERATURE REVIEW)КРОВОСНАБЖЕНИЕ СОСКОВО-АРЕОЛЯРНОГО КОМПЛЕКСА (ОБЗОР ЛИТЕРАТУРЫ)EgorovYu. S.ЕгоровЮ. С.
Russian Federation

23 Kashirskoe Shosse, Moscow 115478; 2/1 Barrikadnaya St., Moscow, 125993

115478 Москва, Каширское шоссе, 24; 125993 Москва, ул. Баррикадная, 2/1, стр. 1

DzottsoevA. K.ДзотцоевА. К.
Russian Federation

23 Kashirskoe Shosse, Moscow 115478; 2/1 Barrikadnaya St., Moscow, 125993

Артур Казгериевич Дзотцоев

115478 Москва, Каширское шоссе, 24; 125993 Москва, ул. Баррикадная, 2/1, стр. 1

ardzot@gmail.comN. N. Blokhin Russian Cancer Research Center, Ministry of Health of RussiaФГБУ «РОНЦ им. Н.Н. Блохина» Минздрава РоссииRussian Medical Academy of Postgraduate Education, Ministry of Health of RussiaФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России2806201713242462806201728062017https://ojrs.abvpress.ru/ojrs/article/view/541

Objective – clarification of the nipple-areolar complex’s (NAC) angioarchitecture.

Materials and methods: search for articles which include the description of the breast angioarchitecture, the description of the several NAC’s blood supply sources and substantiated anatomic data presentation was performed by continuous sampling method in scientific databases. In addition, the information in available anatomic and surgery books was analyzed without special criteria for the selection of used medical literature.

Results. The NAC’s vascularity was grouped in three systems: the medial, which consists of superficial branches of a. thoracica interna and a venous system, which flows into v. thoracica interna system, the central deep system, which consists of perforators of a. thoracoacromialis and aa. intercostales, and the lateral vascular system, consisting of vessels which variably originate from a. thoracica lateralis, a. axillaris and a. thoracoacromialis.

Conclusions. The using of the stable medial vascular system is anatomically substantiated. The central vascular system can be used as additive blood supply source. The lateral system can be used only after pre-examination.

Цель – уточнение ангиоархитектоники сосково-ареолярного комплекса (САК).

Материалы и методы. Осуществлялся поиск статей, включающих описание вариаций ангиоархитектоники молочных желез, описание нескольких источников кровоснабжения САК и анатомическое обоснование представленных данных методом сплошной выборки по научным базам. Также осуществлялся анализ информации доступных анатомических и хирургических учебников без дополнительных условий.

Результаты: кровоснабжение САК подразделено на 3 сосудистые системы: медиальную с поверхностными ветвями a. thoracica interna и подкожной венозной системой, впадающей в систему v. thoracica interna, центральную глубокую с ветвями a. thoracoacromialis и перфорантами aa. intercostales, латеральную сосудистую систему, состоящую из непостоянных ветвей из a. thoracica lateralis, a. axillaris и a. thoracoacromialis.

Заключение. Анатомически обоснованно использовать стабильную медиальную сосудистую систему, центральная сосудистая система может выступать в качестве дополнительного источника кровоснабжения, латеральная сосудистая система может использоваться только после предоперационного обследования.

breast anatomyblood supply to the NACnipple-areolar complexанатомия молочных железкровоснабжение сосково-ареолярного комплекса1. Headon H.L., Kasem A., Mokbel K. The Oncological Safety of Nipple-Sparing Mastectomy: A Systematic Review of the Literature with a Pooled Analysis of 12,358 Procedures. Arch Plas Surg 2016;43(4): 328–38. DOI: 10.5999/aps.2016.43.4.328. PMID: 27462565.Headon H.L., Kasem A., Mokbel K. The Oncological Safety of Nipple-Sparing Mastectomy: A Systematic Review of the Literature with a Pooled Analysis of 12,358 Procedures. Arch Plas Surg 2016;43(4): 328–38. DOI: 10.5999/aps.2016.43.4.328. PMID: 27462565.2. Reid C.D., Taylor G.I. The vascular territory of the acromiothoracic axis. Br J Plast Surg 1984;37 (2):194–212. DOI: 10.1016/0007–1226(84)90010–9. PMID: 6201224.Reid C.D., Taylor G.I. The vascular territory of the acromiothoracic axis. Br J Plast Surg 1984;37 (2):194–212. DOI: 10.1016/0007–1226(84)90010–9. PMID: 6201224.3. Grayʼs anatomy, 41st edition: the anatomical basis of clinical practice. Standring S. (editor). Elsevier Health Sciences, 2015. P. 819–947.Grayʼs anatomy, 41st edition: the anatomical basis of clinical practice. Standring S. (editor). Elsevier Health Sciences, 2015. P. 819–947.4. van Deventer P.V., Graewe F.R. The blood supply of the breast revisited. Plast Reconstr Surg 2016;137(5):1388–97. DOI: 10.1097/PRS.0000000000002048. PMID: 27119914.van Deventer P.V., Graewe F.R. The blood supply of the breast revisited. Plast Reconstr Surg 2016;137(5):1388–97. DOI: 10.1097/PRS.0000000000002048. PMID: 27119914.5. Hall-Findlay E.J. Discussion: The Blood Supply of the Breast Revisited. Plast Reconstr Surg 2016;137 (5):1398–1400. DOI: 10.1097/PRS.0000000000002123. PMID: 27119915.Hall-Findlay E.J. Discussion: The Blood Supply of the Breast Revisited. Plast Reconstr Surg 2016;137 (5):1398–1400. DOI: 10.1097/PRS.0000000000002123. PMID: 27119915.6. mon O’Dey D., Prescher A., Pallua N. Vascular reliability of nipple-areola complex – bearing pedicles: an anatomical microdissection study. Plast Reconstr Surg 2007;119(4):1167–77. DOI: 10.1097/01.prs.0000254360.98241.dc. PMID: 17496587.mon O’Dey D., Prescher A., Pallua N. Vascular reliability of nipple-areola complex – bearing pedicles: an anatomical microdissection study. Plast Reconstr Surg 2007;119(4):1167–77. DOI: 10.1097/01.prs.0000254360.98241.dc. PMID: 17496587.7. Nakajima H., Imanishi N., Aiso S. Arterial anatomy of the nipple-areola complex. Plast Reconstr Surg 1995;96(4):843–5. DOI: 10.1097/00006534-199509001-00012. PMID: 7652057.Nakajima H., Imanishi N., Aiso S. Arterial anatomy of the nipple-areola complex. Plast Reconstr Surg 1995;96(4):843–5. DOI: 10.1097/00006534-199509001-00012. PMID: 7652057.8. Seitz I.A., Nixon A.T., Friedewald S.M. et al. «NACsomes»: A new classification system of the blood supply to the nipple areola complex (NAC) based on diagnostic breast MRI exams. J Plast Reconstr Aesthet Surg 2015;68(6):792–9. DOI: 10.1016/j.bjps. 2015.02.027. PMID: 25733199.Seitz I.A., Nixon A.T., Friedewald S.M. et al. «NACsomes»: A new classification system of the blood supply to the nipple areola complex (NAC) based on diagnostic breast MRI exams. J Plast Reconstr Aesthet Surg 2015;68(6):792–9. DOI: 10.1016/j.bjps. 2015.02.027. PMID: 25733199.9. Palmer J.H., Taylor G.I. The vascular territories of the anterior chest wall. Br J Plast Surg 1986;39 (3):287–99. DOI:10.1016/0007–1226(86)90037–8. PMID: 3730674.Palmer J.H., Taylor G.I. The vascular territories of the anterior chest wall. Br J Plast Surg 1986;39 (3):287–99. DOI:10.1016/0007–1226(86)90037–8. PMID: 3730674.10. Zucca-Matthes G., Urban C., Vallejo A. Anatomy of the nipple and breast ducts. Gland Surg 2016;5(1):32. DOI: 10.3978/j.issn.2227-684X.2015.05.10. PMID: 26855906.Zucca-Matthes G., Urban C., Vallejo A. Anatomy of the nipple and breast ducts. Gland Surg 2016;5(1):32. DOI: 10.3978/j.issn.2227-684X.2015.05.10. PMID: 26855906.11. Rusby J. E., Brachtel E.F., Taghian A. et al. Microscopic anatomy within the nipple: implications for nipple-sparing mastectomy. Am J Surg 2007;194 (4):433–7. DOI: 10.1016/j.amjsurg.2007.06.019. PMID: 17826051.Rusby J. E., Brachtel E.F., Taghian A. et al. Microscopic anatomy within the nipple: implications for nipple-sparing mastectomy. Am J Surg 2007;194 (4):433–7. DOI: 10.1016/j.amjsurg.2007.06.019. PMID: 17826051.12. le Roux C.M., Kiil B.J., Pan W.R. et al. Preserving the neurovascular supply in the Hall-Findlay superomedial pedicle breast reduction: an anatomical study. J Plast Reconstr Aesthet Surg 2010;63 (4):655–62. DOI: 10.1016/j.bjps.2009.01.014. PMID: 19246273.le Roux C.M., Kiil B.J., Pan W.R. et al. Preserving the neurovascular supply in the Hall-Findlay superomedial pedicle breast reduction: an anatomical study. J Plast Reconstr Aesthet Surg 2010;63 (4):655–62. DOI: 10.1016/j.bjps.2009.01.014. PMID: 19246273.13. le Roux C.M., Pan W.R., Matousek S.A. et al. Preventing venous congestion of the nipple-areola complex: an anatomical guide to preserving essential venous drainage networks. Plast Reconstr Surg 2011;127(3):1073–9. DOI: 10.1097/PRS.0b013e3182044bb2. PMID: 21364409.le Roux C.M., Pan W.R., Matousek S.A. et al. Preventing venous congestion of the nipple-areola complex: an anatomical guide to preserving essential venous drainage networks. Plast Reconstr Surg 2011;127(3):1073–9. DOI: 10.1097/PRS.0b013e3182044bb2. PMID: 21364409.14. Freeman J.L., Walker E.P., Wilson J.S. et al. The vascular anatomy of the pectorals major myocutaneous flap. Br J Plast Surg 1981;34(1):3–10. DOI: 10.1016/0007–1226(81)90086–2. PMID: 7459521.Freeman J.L., Walker E.P., Wilson J.S. et al. The vascular anatomy of the pectorals major myocutaneous flap. Br J Plast Surg 1981;34(1):3–10. DOI: 10.1016/0007–1226(81)90086–2. PMID: 7459521.15. Tobin G.R. Pectoralis major segmental anatomy and segmentally split pectoralis major flaps. Plast Reconstr Surg 1985;75(6):814–24. DOI: 10.1097/00006534-198506000-00011. PMID: 4001201.Tobin G.R. Pectoralis major segmental anatomy and segmentally split pectoralis major flaps. Plast Reconstr Surg 1985;75(6):814–24. DOI: 10.1097/00006534-198506000-00011. PMID: 4001201.16. Würinger E., Mader N., Posch E. et al. Nerve and vessel supplying ligamentous suspension of the mammary gland. Plast Reconstr Surg 1998;101(6):1486–93. DOI: 10.1097/00006534-199805000-00009. PMID: 9583477.Würinger E., Mader N., Posch E. et al. Nerve and vessel supplying ligamentous suspension of the mammary gland. Plast Reconstr Surg 1998;101(6):1486–93. DOI: 10.1097/00006534-199805000-00009. PMID: 9583477.17. Hamdi M., Van Landuyt K., Tonnard P. et al. Septum-based mammaplasty: a surgical technique based on Würingerʼs septum for breast reduction. Plast Reconstr Surg 2009;123 (2):443–54. DOI: 10.1097/PRS.0b013e318196b852. PMID: 19182600.Hamdi M., Van Landuyt K., Tonnard P. et al. Septum-based mammaplasty: a surgical technique based on Würingerʼs septum for breast reduction. Plast Reconstr Surg 2009;123 (2):443–54. DOI: 10.1097/PRS.0b013e318196b852. PMID: 19182600.18. Hammond D.C. Atlas of aesthetic breast surgery. Elsevier Health Sciences, 2008. P. 3–5.Hammond D.C. Atlas of aesthetic breast surgery. Elsevier Health Sciences, 2008. P. 3–5.19. Loukas M., du Plessis M., Owens D.G. et al. The lateral thoracic artery revisited. Surg Radiol Anat 2014;36(6):543–9. DOI: 10.1007/s00276-013-1234-x. PMID: 24281130.Loukas M., du Plessis M., Owens D.G. et al. The lateral thoracic artery revisited. Surg Radiol Anat 2014;36(6):543–9. DOI: 10.1007/s00276-013-1234-x. PMID: 24281130.20. Hwang K., Park J.H., Jin S. et al. Anatomy of superficial thoracic artery related to subpectoral augmentation mammoplasty. Ann Plast Surg 2005;55(6):580–2. DOI: 10.1097/01.sap.0000186857.12033.22. PMID: 16327454.Hwang K., Park J.H., Jin S. et al. Anatomy of superficial thoracic artery related to subpectoral augmentation mammoplasty. Ann Plast Surg 2005;55(6):580–2. DOI: 10.1097/01.sap.0000186857.12033.22. PMID: 16327454.21. Taylor G.I., Palmer J.H. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg 1987;40(2):113–41. DOI: 10.1016/0007–1226(87)90185–8. PMID: 3567445.Taylor G.I., Palmer J.H. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg 1987;40(2):113–41. DOI: 10.1016/0007–1226(87)90185–8. PMID: 3567445.