Breast fat and fallacies: more than 100 years of anatomical fantasy

The authors studied the anatomy of 136 patients who underwent breast reduction surgery from 1998 to 2003 to determine the relationship of breast fat to the glandular tissue of the breast. Histological sections of freshly preserved breast tissue taken from representative patients were examined and compared to depictions of normal breast anatomy as portrayed in standard anatomical texts from the classic work of Sir Astley Cooper in 1845 to current publications such as Auberbach and Riordan's Breastfeeding and Human Lactation. Most texts portray little intermix of fat with the glandular tissue of the breast. Our studies confirm the texts that demonstrate the fat and glandular tissue to be inseparable and present in continuity with each other except in the subcutaneous plane where only fat is present. The implications of this anatomical fact as it relates to breast surgery and human lactation are discussed.