To characterize the anatomical pathways and variability of sensory nerves innervating the nipple-areolar complex (NAC), emphasizing the significance of sensory preservation for improved outcomes in breast surgery.
Key Findings:
The anterior cutaneous branch (ACB) and the lateral cutaneous branch (LCB) of the fourth intercostal nerve (ICN) are the primary cutaneous nerves innervating the NAC, with significant contributions from the second, third, and fifth ICNs.
The ACB of the fourth ICN follows a consistent superficial subdermal route, while the LCB traverses deeper breast tissue.
Significant inter-individual anatomical variability was noted in nerve pathways, highlighting the need for personalized surgical approaches.
Interpretation:
The consistent superficial pathway of the ACB of the fourth ICN supports improved sensory preservation in robotic-assisted nipple-sparing mastectomy (rNSM), guiding surgical planning to optimize sensory outcomes and reduce nerve injury.
Limitations:
The study was limited to a small sample size of three cadaveric donors, which may not represent broader populations.
Findings may not be generalizable to all populations due to anatomical variability and potential biases in the literature review.
Conclusion:
Understanding the anatomical pathways of sensory nerves can enhance surgical techniques, leading to better preservation of NAC sensation and improved patient outcomes post-mastectomy, ultimately contributing to better quality of life.
