title: Importance of perforating vessels in nipple-sparing mastectomy: an anatomical description.
abstract: BACKGROUND
  Nipple-sparing mastectomy (NSM), understood as an oncologically valid procedure, is relatively new, and is an evolution of traditional mastectomy, particularly in relation to breast-conserving surgery. The anterior perforating branches are responsible for the cutaneous vascularization of the breast skin, and their preservation is a fundamental step to avoid possible postoperative necrosis. Therefore, evaluating the potential complications of cancer-related reconstructive surgical procedures such as NSM, both the distance of the tumoral lesion from the skin and the surgical incision site should be carefully considered. The preferred site of incision corresponds to the inframammary fold or possibly the periareolar area.
  
  
  METHODS
  We retrospectively reviewed 113 patients who underwent NSM from January 2005 to October 2012 to evaluate skin complications. The anatomical study was performed by magnetic resonance imaging of the breast.
  
  
  RESULTS
  Only one of the 113 women who had undergone a NSM procedure had total necrosis (0.9%) and six patients had partial necrosis (5.8%) of the nipple-areola complex.
authors.affiliation: Breast Surgery Unit, University of Roma, La Sapienza Sant'Andrea Hospital, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Amanti
authors.affiliation: Breast Surgery Unit, University of Roma, La Sapienza Sant'Andrea Hospital, Rome, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Vitale
authors.affiliation: Breast Surgery Unit, University of Roma, La Sapienza Sant'Andrea Hospital, Rome, Italy.
authors.forename: Augusto
authors.initials: A
authors.lastname: Lombardi
authors.affiliation: Breast Surgery Unit, University of Roma, La Sapienza Sant'Andrea Hospital, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Maggi
authors.affiliation: Breast Surgery Unit, University of Roma, La Sapienza Sant'Andrea Hospital, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Bersigotti
authors.affiliation: Breast Surgery Unit, University of Roma, La Sapienza Sant'Andrea Hospital, Rome, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Lazzarin
authors.affiliation: Breast Surgery Unit, University of Roma, La Sapienza Sant'Andrea Hospital, Rome, Italy.
authors.forename: Emiliano
authors.initials: E
authors.lastname: Nuccetelli
authors.affiliation: Breast Surgery Unit, University of Roma, La Sapienza Sant'Andrea Hospital, Rome, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Romano
authors.affiliation: Breast Surgery Unit, University of Roma, La Sapienza Sant'Andrea Hospital, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Campanella
authors.affiliation: Radiology Unit, University of Roma, La Sapienza Sant'Andrea Hospital, Rome, Italy.
authors.forename: Lara
authors.initials: L
authors.lastname: Cristiano
authors.affiliation: Radiology Unit, University of Roma, La Sapienza Sant'Andrea Hospital, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bartoloni
authors.affiliation: Radiology Unit, University of Roma, La Sapienza Sant'Andrea Hospital, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Argento
keywords: breast; breast anatomy; breast perforating vessels; magnetic resonance imaging; nipple-sparing mastectomy