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Congress: ECR25
Poster Number: C-18014
Type: Poster: EPOS Radiologist (educational)
DOI: 10.26044/ecr2025/C-18014
Authorblock: Y. A. Ramirez, C. Matheus; Caracas/VE
Disclosures:
Yariadny Alejandra Ramirez: Nothing to disclose
Cecilia Matheus: Nothing to disclose
Keywords: Anatomy, Breast, Mammography, Complications, Education and training
Learning objectives The nipple-areola complex is an essential visual feature of the breast, which can be affected during breast surgeries not only directly, but also by producing incidental damage to its vascular pedicle. Tomosynthesis can thoroughly evaluate the vascular pedicles that supply the nipple-areola complex, giving the surgeon the knowledge to choose the appropriate surgical technique that preserve the vessels and avoid possible postoperative complications such as necrosis. This method is not only useful in patients with a surgical history where the...
Read more Background MethodsA retrospective, descriptive observational study was carried out interpreting 194 tomosynthesis studies for vascular evaluation carried out at Centro Médico Docente la Trinidad in 2022. First, the findings in tomosynthesis in the MLO and CC projections were interpreted, taking into account the surgical history and the density of the breast tissue according to the ACR, in search of the dominant vascular pedicle, describing the vascular pattern for each breast quadrant and characterizing the vessels according to their diameter to predict...
Read more Findings and procedure details 42% of the patients had type A breast density according to the ACR, 34% type B pattern, 16% type C pattern and only 8% type D pattern. Breast density does not present any difficulty for the assessment of the vascular pattern by tomosynthesis. The breast quadrant that most frequently presented an abundant vascular pattern was the upper internal quadrant with 71%, followed by the upper external quadrant (22%) and a lower percentage of patients with these patterns in the internal and...
Read more Conclusion The Nipple-areola complex irrigation showed a predominance of arteries from the upper quadrants, both from the internal and external mammary arteries, showing an abundant pattern in superior-interior quadrant. Although the majority of patients with vascular silence in the upper quadrants (61%) had a surgical history, 39% still represents a significant number of patients without a history who present this variant and could benefit from presurgical tomosynthesis to plan a better surgical approach that preserves the existing vascular pedicles.Radiologists must be...
Read more References 1. Palazuelos G, Trujillo S, Romero J. Breast tomosynthesis: the new age of mammography tomosíntesis: la nueva era de la mamografía [Internet]. [cited 2024 Dec 25]. Available from: http://contenido.acronline.org/Publicaciones/RCR/RCR25-2/Tomos%C3%ADntesis%20la%20nueva%20era%20de%20la%20mamograf%C3%ADa%20ingles.pdf2. Netter FH. Atlas of Human Anatomy. 7th ed. Philadelphia, Pa: Elsevier; 2019.3. van Deventer PV. The Blood Supply to the Nipple-Areola Complex of the Human Mammary Gland. Aesthetic Plastic Surgery. 2004 Dec;28(6):393–8.4. Nakajima H, Nobuaki Imanishi, Sadakazu Aiso. Arterial Anatomy of the Nipple-Areola Complex. 1995 Sep 1;96(4):843–5. https://doi.org/10.1097/00006534-199509001-000125. Bourahla I, Calibre...
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