title: George Peters Award. Microscopic anatomy within the nipple: implications for nipple-sparing mastectomy.
abstract: BACKGROUND
  Precise anatomical relationships between ducts and vasculature within the nipple remain unknown. This study investigated nipple microvessels and their position relative to ducts.
  
  
  METHODS
  Nipple and duct bundle cross-sectional areas were measured in 48 specimens. Vessels located within the central duct bundle or within a peripheral rim were counted in 7 non-irradiated and 5 irradiated nipples.
  
  
  RESULTS
  Mean nipple diameter was 11.1 mm and duct bundle diameter 5.2 mm. A 2-mm and a 3-mm peripheral rim of nipple tissue would result in complete duct excision in 96% and 87% of sections, respectively. Twenty-nine percent of vessels are located in the duct bundle. A 2-mm rim contains 50%; a 3-mm rim contains 66%. Similar proportions were seen in irradiated nipples.
  
  
  CONCLUSIONS
  This study describes a strategy to balance duct removal with vascular preservation. Ducts can be excised leaving a rim of nipple tissue that contains a large proportion of microvessels.
authors.affiliation: Division of Surgical Oncology, Yawkey 9A, Massachusetts General Hospital, Fruit St, Boston, MA 02114, USA.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Rusby
authors.forename: Elena F
authors.initials: EF
authors.lastname: Brachtel
authors.forename: Alphonse
authors.initials: A
authors.lastname: Taghian
authors.forename: James S
authors.initials: JS
authors.lastname: Michaelson
authors.forename: Frederick C
authors.initials: FC
authors.lastname: Koerner
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Smith
mesh_terms: D005260:Female; D006801:Humans; D008408:Mastectomy / Q000379:methods*; D009558:Nipples / Q000033:anatomy & histology*