From the Guidelines
Breast Anatomy and Breast Cancer Surgery
The anatomy of the breast is crucial in breast cancer surgery, as it comprises the parenchyma, ducts, lobules, and surrounding tissue, including the pectoralis major and minor muscles 1. Understanding the relationship between these structures and the location of tumors is essential for optimal surgical planning, particularly in procedures such as lumpectomy or mastectomy.
- Key anatomical considerations include the Cooper's ligaments, which suspend the breast parenchyma from the overlying skin, and the axillary lymph nodes, which are often assessed for metastasis 1.
- Accurate identification of these structures enables surgeons to achieve clear margins and minimize complications, such as seroma formation.
- Oncoplastic techniques for breast conservation can extend breast-conserving surgical options in situations where the resection itself would likely yield an unacceptable cosmetic outcome 1.
- Breast reconstruction may be an option for any woman receiving surgical treatment for breast cancer, and should be discussed and evaluated preoperatively, considering options such as breast implants, autologous tissue transplantation, or a combination of both 1.
Overall, a thorough understanding of breast anatomy is essential for optimal surgical planning and outcomes in breast cancer surgery, and should be considered in conjunction with the latest clinical guidelines and evidence-based practices 1.
From the Research
Relevance of Breast Anatomy to Breast Cancer Surgery
The anatomy of the breast and surrounding structures is crucial in breast cancer surgery. Understanding the variations and relationships among the pectoralis major, inframammary fold, and pectoralis minor is essential for successful outcomes 2.
Key Anatomical Considerations
- The pectoralis major muscle originates from the sixth rib in 80% of patients and is located above the inframammary fold in 66.67% of patients 2.
- The mean distance between the pectoralis major and inframammary fold is 10.5 mm in patients and 16 mm in cadavers 2.
- The pectoralis major and pectoralis minor muscles cross on the fourth or fifth rib, with an average angle of 23.5° and 21.4° in patients and cadavers, respectively 2.
Implications for Breast Cancer Surgery
- Accurate knowledge of breast anatomy is necessary for axillary surgery, including axillary lymph node dissection and sentinel lymph node biopsy 3, 4.
- Understanding the anatomy of the breast and surrounding structures can help reduce complications, such as arm lymphedema, and improve outcomes in breast cancer surgery 3, 4, 5.
- Breast reconstruction techniques, such as skin-sparing nipple areola hypodermic gland resection and primary breast reconstruction using silicone implants, require a thorough understanding of breast anatomy 6.