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Lymphatics of the female breast: want to learn more about it?

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Lymphatics of the female breast

Learning objectives:

This study unit will help you to:

  1. Understand the importance of the knowledge of the anatomy of the female breast.
  2. Learn the main groups of lymph nodes and vessels draining this structure.

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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. 

The 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 six groups: anterior (pectoral), interpectoral, 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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Summary

Key facts about the lymphatics of the female breast
Lateral pathway Drain most of the female breast
Six groups of axillary lymph nodes:
anterior (pectoral), posterior (subscapular), lateral (brachial or humeral), central, apical and interpectoral
Ultimately drain to the ipsilateral venous angle (sometimes via right lymphatic or thoracic duct)
Medial pathway Parasternal lymph nodes: drain medial quadrants of the breast and the skin apart from the nipple and areola into bronchomediastinal lymph trunks
Deep pathway Drain the deep portions of the breast tissue directly to the subclavicular lymphatic plexus

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