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Blood supply of the mammary gland



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Korenkov Topographic Anatomy (1)

Blood supply of the mammary gland
 
(Fig. A.3)

1) rr. mammarii mediales from rr. perforantes, from a. 
thoracica interna system; 
2) rr. mammarii laterales from a. thoracica lateralis; 
3) rr. perforantes from aa. intercostales. 
Venous drainage to superior vena cava system occurs 
through the homonymous veins. 
The lymph outflows from breast in different ways, what has 
a practical importance in metastastatic spread through these 
ways in cases of malignant growth (breast cancer) (Fig. A.5). 
The main direction of lymph drainage from breast is axillary 
path which begins with 2 – 3 vessels which flow along the 
inferior border as great vessels of pectoralis major muscle and 
flow into nodi lymphoidei pectorales (Sorgius nodes). These 
nodes are located along a. thoracica lateralis on the level of 
the 2nd – 4th ribs. They are the most frequent focuses of 
metastasis. 
From these nodes the lymph drains to axillary lymph nodes, 
nodi lymphoidei axillares centrales, and from nodi lymphoidei 
axillares centrales – to nodi lymphoidei axillares apicales which 


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are located along v. axillaris. From nodi lymphoidei axillares 
apicales the lymph drains to deep inferior cervix nodes or to 
subclavian trunk. The Troisier’s lymph node has a clinical 
relevance which is palpated in metastases above the clavicle 
beside outer edge of sternocleidomastoid muscle. 
From posterior part of mamma the lymphatic vessels go 
along transpectoral path upwards while passing through m. 
pectoralis major, go through nodi lymphoidei interpectorales 
Rotter’s lymph nodes and fascia clavipectorale, and fall into 
nodi lymphoidei axillares apicales or into deep cervix 
(subclavian) nodes.
Moreover, the sternal path is important as well. It begins 
from medial sternal segments, goes through m. pectoralis 
major in intercostal spaces toward nodi lymphoidei 
parasternales which are located along internal sternal vessels. 
From nodi lymphoidei parasternales the lymph drains:
● from the left – into the left subclavian trunk and arch of 
thoracic duct; 
● from the right – into the right subclavian trunk, right 
lymph duct or into nodi lymphoidei prepericardiaci.
Nodi lymphoidei prepericardiaci have connections with 
tracheal and tracheal-bronchial nodes, as well as with 
bronchial-pulmonic and infrapulmonary nodes.
Thus, metastasis of cancer from chest to lungs is possible. 
Along the intercostal lymph vessels, the intercostal lymph 
nodes anastomose with nodi lymphoidei intercostales and 
nodi lymphoidei prevertebrales. Thus, metastasis of cancer 
from chest to corpus vertebrae is possible as well. 
The lymph vessels of right and left mammae are connected 
together as by means of lymphatic reticulum of skin so 
anastomoses of presternal lymph nodes from both sides. 
The metastases of cancerous growths can effuse from 


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presternal lymph nodes along a. epigastrica superior et inferior 
into anteperitoneal cellular tissue, perineal lymph nodes, and 
abdominal cavity and gonads, and along ligamentum teres 
hepatis – into liver. 


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