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KMID : 1134120230260030286
Journal of Breast Cancer
2023 Volume.26 No. 3 p.286 ~ p.291
Anatomy Versus Physiology: Is Breast Lymphatic Drainage to the Internal Thoracic (Internal Mammary) Lymphatic System Clinically Relevant?
Priscilla Machado

Ji-Bin Liu
Laurence Needleman
Christine Lee
Flemming Forsberg
Abstract
Approximately 15%?25% of breast lymphatic drainage passes through the internal thoracic (internal mammary) lymphatic system, draining the inner quadrants of the breast. This study aimed to use lymphosonography to identify sentinel lymph nodes (SLNs) in the axillary and internal thoracic lymphatic systems in patients with breast cancer. Seventy-nine patients received subcutaneous ultrasound contrast agent injections around the tumor. Lymphosonography was used to identify SLNs. In 14 of the 79 patients (17.7%), the tumor was located in the inner quadrant of the breast. Lymphosonography identified 217 SLNs in 79 patients, averaging 2.7 SLNs per patient. The 217 identified SLNs in the 79 patients were located in the axillary lymphatic system; none were located in the internal thoracic (internal mammary) lymphatic system, although it was expected in two to four patients (i.e., 4?11 SLNs). These results implied that SLNs associated with breast cancer are predominantly located in the axillary lymphatic system.
KEYWORD
Breast Neoplasms, Contrast Media, Lymph Nodes, Lymphatic System, Ultrasonography
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