Surgical Anatomy of the Breast

Abstract

Topology of the Breast: An OverviewThe breasts are the most superficial aspect of the anterior chest wall. The skin immediately over the breast tissue is characterized with a nipple areola complex (NAC), centrally located in young adults. The borders of the breast are the second intercostal space superiorly, the midaxillary line laterally, the inframammary line inferiorly, and the sternum medially. The breast overlies the pectoralis major muscle and part of the serratus anterior, external oblique, and rectus abdominus. The NAC is generally located in the fourth and fifth intercostal spaces in males and prepubescent children.Many studies have reported that women's breasts are more frequently asymmetric. 1,2 In a recent study, Avsar et al. measured anthropometric breast values in 386 female students and reported symmetric breast volume in only 35% of subjects. 3 Multiple studies have been done over the years on all aspects of breast anatomy, including arterial supply, venous drainage, and lymphatic patterns. Discrepancies have existed in the published literature in aspects such as lymphatic mapping, dominant arterial supplies, and general vascular patterns. Information presented in the following paragraphs represents the most current research and findings. Along with the currently supported theories, we have also listed papers of historical precedence which are of interest and relevance to all surgeons.