Axillary lymph nodes

Axillary lymph nodes
Lymphatics of the breast and the axillary glands
2. Axillary lymphatic plexus 4. Cubital lymph nodes (not part of the lymph node drainage of the breast) 5. Superficial axillary (low axillary) 6. Deep axillary lymph nodes 7. Brachial axillary lymph nodes 8. Interpectoral axillary lymph nodes (Rotter nodes) 10. Paramammary or intramammary lymph nodes 11. Parasternal lymph nodes (internal mammary nodes)
Details
Drains from	Axilla
Identifiers
Latin	Nodi lymphoidei axillares
TA	A13.3.01.002
FMA	12771 71741, 12771
Anatomical terminology []

The axillary lymph nodes or armpit lymph nodes (20 to 49 in number) drain lymph vessels from the lateral quadrants of the breast, the superficial lymph vessels from thin walls of the chest and the abdomen above the level of the navel, and the vessels from the upper limb. They are divided in several groups according to their location in the armpit. These lymph nodes are clinically significant in breast cancer, and metastases from the breast to the axillary lymph nodes are considered in the staging of the disease.

The axillary lymph nodes are arranged in six groups:

The apical nodes drain into the subclavian lymph trunk. On the left side, this trunk drains into the thoracic duct; on the right side, it drains into the right lymphatic duct. Alternatively, the lymph trunks may drain directly into one of the large veins at the root of the neck.

About 75% of lymph from the breasts drains into the axillary lymph nodes, making them important in the diagnosis of breast cancer. A doctor will usually refer a patient to a surgeon to have an axillary lymph node dissection to see if the cancer cells have been trapped in the nodes. For clinical stages I and II breast cancer, axillary lymph node dissection should only be performed after first attempting sentinel node biopsy.

If cancer cells are found in the nodes it increases the risk of metastatic breast cancer. Another method of determining breast cancer spread is to perform an endoscopic axillary sentinel node biopsy. This involves injecting a dye into the breast lump and seeing which node it first spread to (the sentinel node). This node is then removed and examined. If there is no cancer present, it is assumed the cancer has not spread to the other lymph nodes. This procedure is often less invasive and less damaging than the axillary lymph node dissection. The estimated risk of lymphedema following sentinel lymph node procedure is less than 3%. The approximate risk of lymphedema following axillary lymph node dissection is 10-15% and this can slightly increase with the addition of radiotherapy and chemotherapy to as much as 20-25% depending on the extent of dissection, extent of radiotherapy fields, and history of chemotherapy.