Schnitt S J, Goldwyn R M, Slavin S A
Department of Pathology, Beth Israel Hospital, Boston, Mass.
Plast Reconstr Surg. 1993 Dec;92(7):1290-3.
The use of selective excision of the nipple with preservation of the areola ("nipple coring") has been advocated for patients undergoing subcutaneous or total glandular mastectomy. This is based on the assumption that all the mammary ducts in the nipple-areola complex are located in the nipple and that the areola is devoid of mammary ductal tissue. To investigate this issue, we performed nipple coring on eight consecutive mastectomy specimens, excised the areolas, and submitted them in their entirety for histologic examination. Mammary ducts identical in appearance to extralobular ducts in the breast parenchyma were identified in the dermis of the areola in all eight cases. These ducts were present throughout the areola, including the most peripheral aspects. We conclude that mammary ducts are a normal component of the areolar dermis and that nipple coring does not result in the removal of all mammary ductal tissue from the nipple-areola complex. This observation should be taken into consideration by reconstructive surgeons considering preservation of the areola in patients undergoing subcutaneous or total glandular mastectomy.
对于接受皮下或全腺体乳房切除术的患者，有人主张采用保留乳晕的乳头选择性切除术（“乳头去核术”）。这是基于这样一种假设，即乳头乳晕复合体中的所有乳腺导管都位于乳头内，且乳晕没有乳腺导管组织。为了研究这个问题，我们对连续8个乳房切除标本进行了乳头去核术，切除乳晕，并将其完整送检进行组织学检查。在所有8例病例的乳晕真皮层中均发现了外观与乳腺实质中外叶间导管相同的乳腺导管。这些导管存在于整个乳晕，包括最外围部分。我们得出结论，乳腺导管是乳晕真皮层的正常组成部分，乳头去核术并不能从乳头乳晕复合体中切除所有乳腺导管组织。考虑在接受皮下或全腺体乳房切除术的患者中保留乳晕的重建外科医生应考虑到这一观察结果。
