The anatomical basis for the possible internal mammary artery perforators flaps

Background: conservative therapy for breast tumors respecting the patient psychology is gaining popularity; but it could be followed by deformities especially in dealing with tumors involving the medial part of the breast. The internal mammary artery perforators' flap is widely used for immediate tissue replacement following local excision of tumors in the medial part of the breast. Methods: Ten formalin preserved cadavers from the dissecting room of the Anatomy and Embryology Department, Faculty of Medicine, Alexandria University were used. the beginning of the internal mammary artery was injected with red latex, the perforators of the internal mammary artery were dissected from medial to lateral where the course, length, diameter and branching pattern of each perforator was recorded and photographed. Results: The second internal mammary artery perforator (IMP 2) was the largest constant and the dominant perforator in 55%; it gave arterial supply to the cranial part of the breast; its mean diameter was 2.23± 0.42 mm. The fourth internal mammary artery perforator (IMP 4) was constant in 45%; it gave arterial supply to the caudal part of the breast from the level of the third space and going down. Its mean diameter was 1.95± 0.17 mm. Conclusion: IMPs 2, 3 and 4 could be used in breast reconstruction for the contra lateral breast. IMP 4 could be used to reconstruct the contra lateral breast especially to reconstruct defects following wide local excision in tumors involving the medial part of the contra lateral breast.