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Anatomy of the Pectoral Nerves and Its Significance in Breast Reconstruction

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Breast Reconstruction

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Abstract

The anatomy of the pectoral region is described in relation with the medial and pectoral nerves, recently also classified in three distinct nerves (superior, middle and inferior), with a special stress on the oncological and reconstructive surgery of the breast. The chapter focuses on the different anatomical, functional, and surgical aspects of the medial pectoral nerve and its branches perforating the pectoralis minor muscle to innervate the pectoralis major muscle. The single or multiple branches of the distal medial pectoral nerve are inconsistent for number, caliber, location of the emergence points from the pectoralis minor muscle either from lateral to medial or from the 2nd to the 4th rib longitudinally. A classification is proposed for their variants. In addition the actual amount of pectoralis major innervation is variable in every patient and unpredictable preoperatively. For these reasons, the Authors consider the anatomy knowledge, the observation of the costal attachments of the pectoralis minor muscle, the detection of a longer and larger branch of the medial pectoral nerve, and its cranial dissection eventually, all of these issues as important to avoid iatrogenic drawbacks in the breast implant-based reconstruction after mastectomy.

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Acknowledgement

The Authors are grateful to Elisa Toffoli, medical student, for the anatomical illustration of pectoral nerves.

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Authors and Affiliations

  1. Unit of Plastic and Reconstructive Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, Milano, 20133, Italy

    Egidio Riggio M.D.

  2. Department of Plastic and Reconstructive Surgery, Ancona University Hospital University School of Medicine, Via Tagliamento 37, Ancona, 60100, Italy

    Daniele Bordoni M.D.

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  1. Egidio Riggio M.D.
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  2. Daniele Bordoni M.D.
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Correspondence to Egidio Riggio M.D. .

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Editors and Affiliations

  1. Tustin, California, USA

    Melvin A. Shiffman

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Riggio, E., Bordoni, D. (2016). Anatomy of the Pectoral Nerves and Its Significance in Breast Reconstruction. In: Shiffman, M. (eds) Breast Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-319-18726-6_3

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  • DOI: https://doi.org/10.1007/978-3-319-18726-6_3

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-18725-9

  • Online ISBN: 978-3-319-18726-6

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