Nerve supply of the breast with special reference to the nipple and areola: Sir Astley Cooper revisited

Sarhadi, N.S.; Shaw-Dunn, John; Soutar, David S.

doi:10.1002/(sici)1098-2353(1997)10:4<283::aid-ca12>3.0.co;2-g

Cited by 55 publications

(23 citation statements)

References 17 publications

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“…During an immediate reconstruction, there is also a submuscular dissection, followed by expansion of the prosthesis. The sensory nerve fibers that emerge from the intercostal nerves (17) are interrupted in both dissection planes. A study that compares patients undergoing mastectomy with or without immediate reconstruction would be of interest, to evaluate to what extent the reconstructive part of the operation affects the sensibility in the breast.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Sensibility Following Nonautologous, Immediate Breast Reconstruction

et al. 2007

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n Abstract: Immediate breast reconstruction after mastectomy, using submuscular expander prostheses, is well established in the treatment of breast cancer. The aim of this study was to survey the postoperative cutaneous somatosensory status and to analyze the patients' subjective opinion about the sensibility in the reconstructed breast. Fourteen patients were included and examined 3-6 years after reconstruction. The untreated contralateral breast served as control. None of the patients had received any locoregional radiotherapy. The perception thresholds to touch, cold, warmth, and heat pain were assessed and a questionnaire about the patients' subjective experience of sensibility was completed. In the quantitative somatosensory testing, statistically significant impairment concerning all the examined modalities was demonstrated. The least affected was the heat pain modality. In the questionnaire, the patients reported weaker nonmodality specific sensibility from the reconstructed breast compared with the control breast. More than half of the patients reported that the reconstructed breast felt like a real breast. In conclusion, the study revealed long-term, overall sensibility impairment following nonautologous, immediate breast reconstruction. n

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Section: Discussionmentioning

confidence: 99%

Long-Term Sensibility Following Nonautologous, Immediate Breast Reconstruction

et al. 2007

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“…We kept the catheters from 2 to 7 days depending on the surgery. In 1840, Cooper described mammary branches from the 2 nd to 6th intercostal nerves (4,5). The pectoral fascia originates from the clavicle and sternum, covers PMM, continues inferiorly with the fascia of the abdominal wall to cover the rectus abdominis muscle and external oblique muscle and continues laterally with the fascia of the back to cover the serratus anterior muscle (SAM) (6)(7)(8).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Continuous Interpectoral Block for Patient Undergoing Mastectomy and Axillary Clearance

Pérez¹,

Altınpulluk²,

Miguel³

et al. 2017

Turk J Anaesth Reanim

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Using a single dose of local anaesthetics has some disadvantages and provides limited analgesia depending on the pharmacokinetic characteristics of the local anaesthetic used. Nevertheless, the use of continuous perineural infusions allows sustained pain control. Ultrasound-guided interpectoral block followed by the placement of catheters in patients undergoing mastectomies with or without lymph node axillary dissections can result in sufficient pain control. We present a case of a 58-year-old woman undergoing mastectomy and axillary clearance who received ultrasound-guided continuous interpectoral block for postoperative analgesia. After the induction of general anaesthesia, interpectoral ultrasound block was performed and levobupivacaine was administered through a catheter placed between the pectoralis minor and pectoralis major muscles using an ultrasound-guided technique. We used an elastomeric pump containing the 0.125% levobupivacaine anaesthetic solution, with an infusion rate of 5 mL h -1 for 48 h. Excellent postoperative pain control was observed. Local anaesthetic-and catheter-related side-effects were not observed. The ideal infusion rate for interpectoral block in patients under mastectomy has not been determined. More randomised studies are needed to confirm whether interpectoral techniques are appropriate for routine clinical practice.Keywords: Mastectomy and axillary clearance, continuous interpectoral block, pain control Tek doz bir lokal anestetik kullanımının bazı dezavantajları vardır ve kullanılan lokal anestetiğin farmakokinetik özel-liklerine bağlı olarak sınırlı analjezi sağlar. Bununla birlikte, devamlı perinöral infüzyonların kullanımı uzun süreli ağrı kontrolüne olanak sağlar. Lenf nodu aksiller disseksiyonu ile veya olmadan mastektomi uygulanan hastalarda, kateter yerleştirilmesinin izlediği ultrason eşliğinde interpektoral blok yeterli ağrı kontrolü ile sonuçlanabilir. Bu vaka çalışmasın-da mastektomi ve aksiller klerens uygulanan ve postoperatif analjezi için ultrason eşliğinde devamlı interpektoral blok alan 58 yaşında bir kadın hasta sunulmaktadır. Genel anestezi indüksiyonundan sonra interpektoral ultrason gerçekleştirildi ve levobupivakain ultrason eşliğinde pektoral minör ve pektoral majör kasları arasına yerleştirilen bir kateterden uygulandı. 48 saat boyunca 5 mL saat -1 infüzyon hızında, %0,125 levobupivakain içeren elastomerik pompa kullanıldı. Mükemmel postoperatif ağrı kontrolü izlendi. Lokal anestetik ve kateterle ilişkili yan etkiler görülmedi. Mastektomi altındaki hastalarda interpektoral blok için ideal infüzyon hızı belirlenmemiştir. İnterpektoral tekniklerin rutin klinik uygulama için uygun olup olmadığını teyit etmek için daha fazla sayıda randomize çalışmaya ihtiyaç vardır.Anahtar Sözcükler: Mastektomi ve aksiller klerens, devamlı interpektoral blok, ağrı kontrolü Abstract / Öz

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“…The sensation was most affected above the areola. This might be explained by the surgical dissection, which is more extended in this direction both in the mastectomy and in the submuscular dissection, interrupting sensory nerve fibers emerging from the intercostal nerves (24) in two anatomic planes. In a study by Benediktsson et al.…”

Section: Discussionmentioning

confidence: 99%

Sensation Following Immediate Breast Reconstruction with Implants

Lagergren¹,

Wickman²,

Hansson³

2010

The Breast Journal

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Sensation is a neglected aspect of the outcome of breast reconstructions with implants. The aim of this prospective study was to evaluate the cutaneous somatosensory status in breasts following mastectomy and immediate reconstruction with permanent adjustable prostheses and to analyze the patients' subjective experience of the sensation. Twenty-four consecutive patients diagnosed with invasive or in situ breast carcinoma were examined preoperatively and 2 years after mastectomy and reconstruction, for assessment of perception thresholds for touch, cold, warmth, and heat pain above and below the areola. Von Frey filaments and a Peltier element-based thermode were used. The patients completed a questionnaire concerning their experienced sensation in the reconstructed breast. Using quantitative somato-sensory testing, the sensation to all the examined modalities was significantly impaired compared to preoperatively. Most affected was the area above the areola. Patients given postoperative radiotherapy (n = 9) did not differ from those without radiotherapy (n = 15) regarding any of the modalities. All patients reported reduced sensation in the reconstructed breast compared to that preoperatively. Twenty-three patients stated that the reconstructed breast felt different from the other breast; nevertheless 16 reported that the reconstructed breast felt like a real breast. The study revealed sensation impairment following mastectomy and immediate reconstruction with implants. Patients should be informed about this effect preoperatively to allow adequate expectations regarding the sensation outcome. However, two-thirds of the study patients considered that the reconstructed breast felt like a real breast, which must be one of the main purposes of a breast reconstruction.

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Nerve supply of the breast with special reference to the nipple and areola: Sir Astley Cooper revisited

Cited by 55 publications

References 17 publications

Long-Term Sensibility Following Nonautologous, Immediate Breast Reconstruction

Long-Term Sensibility Following Nonautologous, Immediate Breast Reconstruction

Ultrasound-Guided Continuous Interpectoral Block for Patient Undergoing Mastectomy and Axillary Clearance

Sensation Following Immediate Breast Reconstruction with Implants

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