Skip to main content
SpringerLink
Log in

Breast and Lymph Node Anatomy

  • Chapter
  • First Online:
Breast Cancer Radiation Therapy

  • 721 Accesses

Abstract

Breast is a complex organ with rich blood and nerve supply and various pathways of lymphatic drainage. The knowledge of its anatomy and possible variants is essential for targeting breast cancer management from diagnosis, through surgery, radiation and medical treatments, to follow up. In this chapter, the anatomy of the breast, thoracic wall and axilla is presented with emphasis on the various lymphatic pathways. Detailed figures, schemes and drawings are provided to get the reader familiar with different anatomical structures, their location and topographical anatomy including CT cross-sectional anatomy. Several clinically relevant aspects of anatomy and its variations are discussed, including their clinical impact on the patient’s outcomes including quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Chiu SY, Duffy S, Yen AM, Tabár L, Smith RA, Chen HH. Effect of baseline breast density on breast cancer incidence, stage, mortality, and screening parameters: 25-year follow-up of a Swedish mammographic screening. Cancer Epidemiol Biomark Prev. 2010;19(5):1219–28.

    Article  Google Scholar 

  2. Lesavoy MA, Gomez-Garcia A, Nejdl R, Yospur G, Syiau TJ, Chang P. Axillary breast tissue: clinical presentation and surgical treatment. Ann Plast Surg. 1996;36(6):661–2.

    Article  Google Scholar 

  3. Parks AG. The micro-anatomy of the breast. Ann R Coll Surg Engl. 1959;25(4):235–51.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. D'Orsi CJ. Imaging for the diagnosis and management of ductal carcinoma in situ. J Natl Cancer Inst Monogr. 2010;2010(41):214–7.

    Article  Google Scholar 

  5. Love SM, Barsky SH. Anatomy of the nipple and breast ducts revisited. Cancer. 2004;101(9):1947–57.

    Article  Google Scholar 

  6. Rusby JE, Brachtel EF, Michaelson JS, Koerner FC, Smith BL. Breast duct anatomy in the human nipple: three-dimensional patterns and clinical implications. Breast Cancer Res Treat. 2007;106(2):171–9.

    Article  Google Scholar 

  7. Stecco L. Functional atlas of the human fascial system. London: Churchill Livingstone; 2014.

    Google Scholar 

  8. Palhazi P. Gross anatomy of the breast and axilla. In: Wyld L, Markopoulos C, Leideius M, Senkus-Konefka E, editors. Breast cancer management for surgeons’ book. New York: Springer; 2018.

    Google Scholar 

  9. Awad MA, Sherif MM, Sadek EY, Helal HA, Hamid WR. A new septum in the female breast. Arch Plast Surg. 2017;44(2):101–8.

    Article  Google Scholar 

  10. Michelle le Roux C, Kiil BJ, Pan WR, Rozen WM, Ashton MW. Preserving the neurovascular supply in the Hall-Findlay superomedial pedicle breast reduction: an anatomical study. J Plast Reconstr Aesthet Surg. 2010;63(4):655–62.

    Article  Google Scholar 

  11. Sarhadi NS, Shaw Dunn J, Lee FD, Soutar DS. An anatomical study of the nerve supply of the breast, including the nipple and areola. Br J Plast Surg. 1996;49(3):156–64.

    Article  CAS  Google Scholar 

  12. Henry BM, Graves MJ, Pękala JR, Sanna B, Hsieh WC, Tubbs RS, Walocha JA, Tomaszewski KA. Origin, branching, and communications of the intercostobrachial nerve: a meta-analysis with implications for mastectomy and axillary lymph node dissection in breast cancer. Cureus. 2017;9(3):e1101.

    PubMed  PubMed Central  Google Scholar 

  13. Gray H. Anatomy of the human body. Philadelphia: Lea & Febiger; 1918.

    Book  Google Scholar 

  14. Soares EW. Anatomical variations of the axilla. Springerplus. 2014;24(3):306.

    Article  Google Scholar 

  15. Suami H, Pan WR, Mann GB, Taylor GI. The lymphatic anatomy of the breast and its implications for sentinel lymph node biopsy: a human cadaver study. Ann Surg Oncol. 2008;15(3):863–71.

    Article  Google Scholar 

  16. Turner-Warwick RT. The lymphatics of the breast. Br J Surg. 1959;46:574–82.

    Article  CAS  Google Scholar 

  17. Földi M, Földi E, Kubik S. Lehrbuch lymfologie. Munich: Elsevier; 2005. p. 119–22.

    Google Scholar 

  18. Földi M, Földi E, Kubik S. Lehrbuch lymfologie. Munich: Elsevier; 2005. p. 123.

    Google Scholar 

  19. Berg JW. The significance of axillary node levels in the study of breast carcinoma. Cancer. 1955;8(4):776–8.

    Article  CAS  Google Scholar 

  20. Vendrell-Torné E, Setoain-Quinquer J, Doménech-Torné FM. Study of normal mammary lymphatic drainage using radioactive isotopes. J Nucl Med. 1972;13(11):801–5.

    PubMed  Google Scholar 

  21. Hultborn KA, Larsson LG, Ragnhult I. The lymph drainage from the breast to the axillary and parasternal lymph nodes, studied with the aid of colloidal Au198. Acta Radiol. 1955;43(1):52–64.

    Article  CAS  Google Scholar 

  22. Estourgie SH, Nieweg OE, Olmos RA, Rutgers EJ, Kroon BB. Lymphatic drainage patterns from the breast. Ann Surg. 2004;239(2):232–7.

    Article  Google Scholar 

  23. Grossman F. Ueber die axillaren Lymphdrusen. Inaug. Dissert. Berlin, 1896. Rotter J. Zur topographie des Mammacarcinoms. Arch Klin Chir. 1899;58:346.

    Google Scholar 

  24. Cody HS, Egeli RA, Urban JA. Rotter’s node metastases. Therapeutic and prognostic considerations in early breast carcinoma. Ann Surg. 1984;199(3):266–70.

    Article  Google Scholar 

  25. Mornard P. Étude anatomique des lymphatiques de la mammelle au point de vue de l’extension lymphatique des cancers. Rev Chir. 1916;11(5-6):492–501.

    Google Scholar 

  26. Grotenhuis BA, Klem TM, Vrijland WW. Treatment outcome in breast cancer patients with ipsilateral supraclavicular lymph node metastasis at time of diagnosis: a review of the literature. Eur J Surg Oncol. 2013;39(3):207–12.

    Article  CAS  Google Scholar 

  27. Ellis H, Colborn GL, Skandalakis JE. Surgical embryology and anatomy of the breast and its related anatomic structures. Surg Clin North Am. 1993;73(4):611–32.

    Article  CAS  Google Scholar 

  28. Perre CI, Hoefnagel CA, Kroon BB, Zoetmulder FA, Rutgers EJ. Altered lymphatic drainage after lymphadenectomy or radiotherapy of the axilla in patients with breast cancer. Br J Surg. 1996;83(9):1258.

    CAS  PubMed  Google Scholar 

  29. Rosen PP, Lesser ML, Kinne DW, Beattie EJ. Discontinuous or “skip” metastases in breast carcinoma. Analysis of 1228 axillary dissections. Ann Surg. 1983;197(3):276–83.

    Article  CAS  Google Scholar 

  30. Troupis T, Michalinos A, Skandalakis P. Intramammary lymph nodes: a question seeking for an answer or an answer seeking for a question? Breast. 2012;21(5):615–20.

    Article  CAS  Google Scholar 

  31. Brierley JD, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumours. Hoboken: Wiley; 2017.

    Google Scholar 

  32. Fornage BD. Local and regional staging of invasive breast cancer with sonography: 25 years of practice at MD Anderson Cancer Center. Oncologist. 2014;19(1):5–15.

    Article  Google Scholar 

  33. Marino MA, Avendano D, Zapata P, Riedl CC, Pinker K. lymph node imaging in patients with primary breast cancer: concurrent diagnostic tools. Oncologist. 2020;25(2):e231–42.

    Article  Google Scholar 

Download references

Acknowledgements

Special thanks to Barbora Vyhnankova M.D., Department of Surgery, University Hospital Kralovske Vinohrady, Prague, Czech Republic, for original drawings and schemas.

Author information

Authors and Affiliations

  1. Breast Cancer Screening and Diagnostic Centre, Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic

    Petra Steyerova

  2. Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic

    David Kachlik

Authors
  1. Petra Steyerova
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David Kachlik
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Petra Steyerova .

Editor information

Editors and Affiliations

  1. Radiation Oncology Unit, Sheba Medical Center, Ramat Gan, Israel

    Orit Kaidar-Person

  2. Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    Icro Meattini

  3. Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

    Philip Poortmans

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Steyerova, P., Kachlik, D. (2022). Breast and Lymph Node Anatomy. In: Kaidar-Person, O., Meattini, I., Poortmans, P. (eds) Breast Cancer Radiation Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-91170-6_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-91170-6_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-91169-0

  • Online ISBN: 978-3-030-91170-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation