Lymphatic drainage of the mammary gland. Sentinel node biopsy revisited at the light of historical anatomical works

Seance of wednesday 08 february 2006 (pas de sujet Principal)

Abstract

Sentinel node biopsy for breast cancer was described in 1994 and ispart of the daily treatment of small operable breast cancers.Colorimetric and/or isotopic technique allows identification ofbreast lymphatic network and its drainage towards the axilla. Periareolaror peri-tumoral injection of the Isotope or patent blue weredemonstrated as injecting the same axillary node or group of nodes.The anatomy of the breast lymphatic drainage was described in the19th century and before Sappey’s description one can say that theaesthetical and lactation diseases were the main concerns about thebreast.Even though Queen Anne d’Autriche was treated with red iron forher T IV, the treatment of breast cancer remained poorly describeduntil the end of the 19th century.Screening programs allow the discovery of smaller and smallercancers in which the classical axillary dissection is no more useful.Identification of breast lymphatic drainage rediscovered the ancients’anatomical works with lymphotropic dye and isotopes whichcan be used in vivo. The re-discovery of the anatomy by these authorsis very valuable and very useful for our patients