The lymphatic anatomy of the breast and its implications for sentinel lymph node biopsy: A Human Cadaver Study
The lymphatic anatomy of the breast and its implications for sentinel lymph node biopsy: A Human Cadaver Study
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DOI：
10.1245/s10434-007-9709-9
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发表时间：
2008-03-01
影响因子：
3.7
通讯作者：
Taylor, G. Ian
中科院分区：
文献类型：
--
作者：
Suami, Hiroo;Pan, Wei-Ren;Taylor, G. Ian
背景资料：目前对乳腺淋巴系统的认识主要来自解剖学家Sappey在19世纪50年代的工作，在发展和引进乳腺淋巴映射和前哨淋巴结活检有助于我们的knowledge.Methods：24乳房14新鲜人尸体（5男，9女）进行了研究。用过氧化氢鉴别淋巴管，注射氧化铅混合物并进行X射线照相。对标本进行横截面和X线摄影，以提供三维图像。结果：在躯干前上缘周围发现均匀分布的淋巴（收集）血管，呈放射状引流至腋窝淋巴结。如横截面研究所示，当它们到达乳房时，一些通过了乳房实质，一些通过了乳房实质。这些通路在男性和女性样本之间没有显着差异。我们还发现穿通淋巴管走行在内乳血管分支旁，汇入同侧内乳血管。在一些研究中，腋窝的一个前哨淋巴结几乎引流了整个乳房。在最多的一个以上的前哨淋巴结represented.Conclusion：这些解剖结果是不一致的，我们目前的知识，根据以往的研究，需要临床医生进行更仔细的检查。这些解剖学研究可能有助于解释前哨淋巴结活检假阴性的百分比，并建议肿瘤周围注射部位进行准确的前哨淋巴结检测。
Background: Current understanding of the lymphatic system of the breast is derived mainly from the work of the anatomist Sappey in the 1850s, with many observations made during the development and introduction of breast lymphatic mapping and sentinel node biopsy contributing to our knowledge.Methods: Twenty four breasts in 14 fresh human cadavers (5 male, 9 female) were studied. Lymph vessels were identified with hydrogen peroxide and injected with a lead oxide mixture and radiographed. The specimens were cross sectioned and radiographed to provide three dimensional images. Lymph (collecting) vessels were traced from the periphery to the first-tier lymph node.Results: Lymph collecting vessels were found evenly spaced at the periphery of the anterior upper torso draining radially into the axillary lymph nodes. As they reached the breast some passed over and some through the breast parenchyma, as revealed in the cross-section studies. The pathways showed no significant difference between male and female specimens. We found also perforating lymph vessels that coursed beside the branches of the internal mammary vessels, draining into the ipsilateral internal mammary lymphatics. In some studies one sentinel node in the axilla drained almost the entire breast. In most more than one sentinel node was represented.Conclusion: These anatomical findings are discordant with our current knowledge based on previous studies and demand closer examination by clinicians. These anatomical studies may help explain the percentage of false-negative sentinel node biopsy studies and suggest the peritumoral injection site for accurate sentinel lymph node detection.