Aims: 

The up-to-date therapy of breast cancer includes several therapeutic approaches, however, surgical interventions cannot be excluded. Partial or total mastectomy results in the removal of excessive tissue leaving the patients with certain disfiguration. The physical asymmetry, together with the psychological impactof "being asymmetrical" has led to the development of several breast reconstructing techniques. Most of these methods, (e.g. Latissimus Dorsi Myocutaneous flap, Transverse Rectus Abdominus Myocutaneous, Thoracoepigastrialis flap, TRAM microvascular free flap) employ autologous tissues to replace the missing morphological entities where the pivotal question is to maintain the blood supply of the transplanted flap. Either the myocutaneous flap is dissected together with a vascular pedicle, or, in other cases, the local perforator arteries will supply the transplanted free flap (e.g. Superficial or Deep Inferior Epigastric Perforator flaps).

Methods: 

Both male (5) and female (4) cadaver dissections were perfomed using formaline preserved chest preparations to describe the arterial arborization within the mammary region, including the nipple areola complex.

Results: 

The mammary region can arbitrarily be divided into 4 quadrants where the arterial supply derives from the direct or perforator branches of the internal thoracic, the thoracoacromial and the lateral thoracic vessels together with the anterior and posterior intercostal arteries. In males, the perforator vessels of the internal thoracic artery has been found smaller in diameter than in females and generally the first three intercostal spaces have contained the largest perforator branches. The lateral perforator branches were most prominent between the 5th and 8th intercostal spaces.

We have found a direct axillary branch supplying the nipple-areola complex similar to that described by van Deventer et al. in 2004.

Conclusions: 

Both the lateral intercostal and medial internal thoracic perforator arteries are suggested to use in surgery, to preserve the integrity of the larger direct branches, such as the thoracoacromial pedicle of the latissimus dorsi muscle.