Applied anatomical relation between upper arm lymphatic drainage and axillary lymph node, and its significance

ObjectiveTo provide the anatomical basis in preserving the upper limb lymphatic drainage to alleviate upper limb lymphedema during the sentinel lymph node biopsy (SLNB) and axillary lymph node (ALN) dissection (ALND) in breast cancer patients.

MethodsThe axillary region and proximal upper arm region of 40 sides in female adult cadavers were dissected, and the number and location of lymph node in each axillary region were observed.The relationships among the superficial lymphatic reflux of proximal upper arm, axillary lymph node and axillary vein were analyzed.

ResultsThe average number of lateral ALN, subscapularis ALN, pectoral ALN, central ALN and apical ALN was (3±1.3) (4±1.8) (4±1.1) (5±1.3) and (2±1.3), respectively.The superficial lymphatic drainage of upper limb draining into basilic vein in 12 cases (30.0%), lateral ALN in 25 cases (62.5%), central ALN in 13 cases (32.5%) and axillary vein in 20 cases (50.0%) were identified.

ConclusionsPreservating the axillary reverse mapping lymphatic drainage and lymph nodes during ALND and SLNB can effectively protect the upper limb lymphatic drainage.