Title : Lymphatic drainage of breast : Clinicoanatomical perspective in Carcinoma breast
Abstract:
One of the most frequent types of neoplastic diseases in females worldwide is breast cancer resulting in significant morbidity and mortality. The commonest route of spread of breast tumor cells is via lymphatics and blood. We as anatomists would like to impress upon the lymphatic anatomy of breast. One of the cardinal factors determining the clinical presentation, diagnosis, staging, management and prognosis of carcinoma breast is the knowledge of involved lymph nodes – the area they drain, their anatomical location, adjacent relations and connections. The breast cancer cells metastasize to regional lymph nodes and thence travel to distant sites giving rise to secondaries. The speaker would like to take this opportunity to describe the lymphatics of mammary gland. The lymphatic drainage of parenchyma of the breast and the overlying skin will be discussed followed by the anatomical basis of clinical presentation of breast cancer. The anatomical and surgical classification of lymph nodes draining the breast tissue will be detailed along with their locations, connections and anatomical relations. The knowledge helps in clinical examination of axillary, supraclavicular and parasternal lymph nodes. It helps the oncologist to plan diagnostic and therapeutic interventions, predict the potential sites of secondaries by identifying the major routes of lymphatic metastasis, and explains the clinical experience in mapping the breast lymphatics, sentinel lymph node biopsy and axillary lymph node dissection. Knowing the anatomical location of sentinel node helps in focussed surgical dissection and radiotherpy thereby reducing post operative morbidity and lymphedema.
