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Lymph Drainage of the Upper Limb and Mammary Region to the Axilla. Anatomical Study in Stillbirths
Author(s) -
Cuadrado Guilherme,
Andrade Mauro,
Akamatsu Flavia,
Jacomo Alfredo
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.552.12
Subject(s) - lymph , medicine , lymphedema , axilla , lymphatic system , upper limb , axillary lymph nodes , anatomy , fascia , lymph node , breast cancer , surgery , cancer , pathology
The aim of this study was to investigate the lymphatic pathways of the upper limb and the breast in the axillary region to evaluate the occurrence of anastomoses and shared drainage, assessing the safety of the Axillary Reverse Mapping (ARM) to preserve arm lymph nodes in breast cancer treatment. Modified Gerota mass was injected intradermally in the periareolar area, the palm and back of the hand of unfixed stillbirths. They were submerged in H₂O₂ before microsurgical dissection of the superficial fascia of the upper limb, the axillary region and the anterior thorax to expose the lymphatic pathways.It was approved by the the Ethics Committee nº 134/13. We observed the dye injected in the upper limb reached either the lateral group, referred as the major area related to the upper limb, or the anterior group, which is tipically related to breast drainage. It was found great proximity among the pathways and the lymph nodes, besides communicating lymphatic vessels among the breast and upper limb lymph nodes in all studied cases.ARM is an alternative to avoid postoperative lymphedema, but, despite possible anatomical changes during growth, it seems ARM should be further studied before implementation in clinical practice for it may present potential oncological risks because the preserved lymph nodes may harbor malignant cells due to lymph nodes proximity, overlapping drainage and connecting lymph vessels among lymph nodes.