Deep lymphatic vessels (breast)

There are four deep lymphatic channels for drainage of the breast:

• superior trunk:
  • originates from subareolar plexus around nipple
  • drains from
    • superficial and deep tissue around nipple, areola and periareolar region
    • parenchymal tissues of outer half of the breast
  • pierces fascia at the lateral border of pectoralis major to run to axillary nodes

inferior trunk:

þþ originate in subareolar plexus

• receives lymphatics from the medial half of the breast
• takes same route as superior trunk to axilla
• transpectoral lymphatics:
  • arise from deepest surface of breast
  • pass through pectoralis major
  • pass along route of pectoral branch of thoraco-acromial artery
  • distribute lymph to apical axillary nodes
• retropectoral lymphatics:
  • originate in the superomedial parts of the deep breast
  • pass laterally deep to pectoralis major
  • supply the apical group of nodes

These must be contrasted with the cutaneous lymphatics.