Lymphatics of the female breast

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In the context of mammary carcinoma/breast cancer, a knowledge of the anatomy of the lymphatics of the female breast is of utmost importance in the staging and treatment of this disease. 

Lymph from the breast tissue and adjacent structures usually take three main routes of drainage:

• Most of the lymph from the nipple, areola and breast lobules (especially those from the lateral quadrants) are drained into a lateral route by the subareolar lymphatic plexus. From there the lymph is carried to the axillary lymph nodes. Those are subdivided into five groups: anterior (pectoral), posterior (subscapular), lateral (brachial or humeral), central and apical. Lymphatic vessels draining these large node groups converge to form the subclavian lymph trunk(s). The left and right subclavian lymph trunks most commonly open independently into the ipsilateral venous angle (junction of subclavian and internal jugular veins), but can also join the jugular and/or bronchomediastinal lymph trunk of the same side - forming a right lymphatic duct on the right side, or joining the thoracic duct on the left.  This route drains over 75% of the lymph from the breast tissue.

• A medial pathway is composed mainly of parasternal lymph nodes that drain lymph mostly from the medial quadrants of the breast tissue and enter the bronchomediastinal lymph trunks, which usually independently drain into ipsilateral venous angle. 
• The deeper portions of the breast tissue usually drain directly to the subclavicular lymphatic plexus through a deep pathway.

Watch the video below to further your understanding of the lymphatics of the female breast.

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Browse atlas

Take a closer look at the lymph nodes and vessels of the female breast in the gallery below.

Summary