I just came across an abstract for two papers I plan to fully read.  The
first is:  Wuringer E, Mader N, Posch E, Holle J:  Nerve and vessel
supplying ligamentous suspension of the mammary gland.  Plast Reconstr Surg
1998, 101(6):1486-93.

The abstract describes anatomical findings from dissections of breasts from
female corpses.  They discovered "a thin horizontal fibrous septum,
originating from the pectoral fascia along the level of the fifth rib,
heading toward the nipple.  This fibrous spetum lies in between a cranial
and a caudal vascular network, and being mesentery-like, it is responsible
for the supply of the nipple areolar complex...it is also a guiding
structure for the mail supplying nerve of the nipple....These two
structures, the fibrous sling and the vascular and nervous membranes
attached to it, are consistent anatomical findings, WHICH HAVE NOT BEEN
DESCRIBED BEFORE [my emphasis].  Their knowledge could be of value and
relevance in clinical applications."


Another article, Schlenz I, Kuzbari R, Gruber H, Holle J:  The sensitivity
of the nipple-areolar complex:  an anatomic study, Plast Reconstr Surg 2000,
105(3):905-9, states:

"Although preservation of the sensitivity of the nipple and areola is an
impt. goal in breast surgery, ONLY SCANT AND CONTRADICTORY INFORMATION ABOUT
THE COURSE AND DISTRIBUTION OF THE SUPPLYING NERVES IS FOUND IN THE
LITERATURE [my emphasis]."

This article goes on to document results of dissections which demonstrate
that the pathways of the 3rd, 4th, and 5th intercostal nerves (which supply
sensation to the nipple/areolar complex) have somewhat variant paths in
individuals.  The article makes some general conclusions about where to
avoid resections (at the base of the breast and skin incisions at the medial
areolar border).

I am grateful someone finally bothered to look, but what strikes me is how
can efforts to dissect and study the female breast be so retarded when you
consider the frequency of breast surgery???  The nerve supply to the
nipple/areolar complex is critical to lactation and to sexual stimulation
(in some populations, anyway).  I work with many women who have altered
sensation in the nipples and in their breasts following such surgery, and it
can impair their production.


Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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