Breast
Source region and uptake · 75% axilla Medial to parasternal
About three-quarters of breast lymph passes laterally to the axillary nodes; lymph from the medial quadrants crosses to the parasternal (internal mammary) chain and so bypasses the axilla altogether.
Detail
- To the axilla
- About 75%
- Medial quadrants
- Parasternal (internal mammary) nodes
- Nipple and areola
- Subareolar plexus of Sappey
- Other routes
- Opposite breast and subdiaphragmatic (rectus sheath) lymphatics
- Staging tool
- Sentinel node biopsy with blue dye plus technetium-99m colloid
When it goes wrong
Medial quadrant carcinoma draining to parasternal nodes
Nodal spread with a clinically and pathologically negative axilla
Tumour obstructing dermal lymphatics
Peau d'orange and inflammatory breast carcinoma
Practise this structure
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