Analysis of Arterial Blood Supply to the Nipple-Areola Complex, An Imaging Study.

Abstract

Background: The nipple–areola complex represents an important aesthetic and functional unit of the breast. Accurate knowledge of its arterial blood supply is essential during breast reduction, mastopexy, and reconstructive breast surgery to reduce the risk of ischemia and nipple–areola complex necrosis.

Methods: This observational descriptive imaging study was conducted at the Computed Tomography Unit, Badr University Hospital, Helwan University. Forty female volunteers underwent contrast-enhanced computed tomography scanning of the thorax and thoracic organs. The nipple–areola complex was identified on reconstructed images, and arteries terminating in the peri-areolar region were traced to determine their source, course, dominance, reproducibility, and mode of entry.

Results: The study included 40 female participants, with a total of 80 breasts. The mean age was 37 years, ranging from 18 to 60 years, and the mean BMI was 24, ranging from 21 to 29. The internal thoracic artery was the most common source artery for nipple–areola complex perfusion, being reproducible in 77.1% and dominant in 75% of cases. The lateral thoracic artery was reproducible in 22% and dominant in 21% of cases. A single-source arterial pattern was observed in most breasts, while dual-source supply was detected in 12.5%. The arterial supply pattern between both breasts was mostly asymmetric, with symmetry observed in 42.5% of participants.

Conclusion: The arterial blood supply to the nipple–areola complex arises mainly from the internal thoracic artery and lateral thoracic artery, with greater dominance and reproducibility of the internal thoracic artery. The frequent asymmetry between both breasts highlights the importance of individualized vascular assessment before breast surgery.