The Lymphatic System in Breast Cancer: Anatomical and Molecular Approaches

Abstract

Breast cancer is one of the most important causes of premature mortality among women and it is one of the most frequently diagnosed tumours worldwide. For this reason, routine screening for prevention and early diagnosis is important for the quality of life of patients. Breast cancer cells can enter blood and lymphatic capillaries, then metastasizing to the regional lymph nodes in the axilla and to both visceral and non-visceral sites. Rather than at the primary site, they seem to enter the systemic circulation mainly through the sentinel lymph node and the biopsy of this indicator can influence the axillary dissection during the surgical approach to the pathology. Furthermore, secondary lymphoedema is another important issue for women following breast cancer surgical treatment or radiotherapy. Considering these fundamental aspects, the present article aims to describe new methodological approaches to assess the anatomy of the lymphatic network in the axillary region, as well as the molecular and physiological control of lymphatic vessel function, in order to understand how the lymphatic system contributes to breast cancer disease. Due to their clinical implications, the understanding of the molecular mechanisms governing lymph node metastasis in breast cancer are also examined. Beyond the investigation of breast lymphatic networks and lymphatic molecular mechanisms, the discovery of new effective anti-lymphangiogenic drugs for future clinical settings appears essential to support any future development in the treatment of breast cancer.

Localization of Central Breast Lymphatics and Predefined Separation of Lobes along the Horizontal Septum

“…Its corresponding part can be included in the resection in cases of suspected lymphatic invasion or affected lymph nodes. A possible advantage of this septum-based approach, at least in certain oncoplastic settings, 37 may be the subject of further investigation. This seems to be promising, especially for tumors near the NAC.…”

68Ga-labeled amphiphilic polymer nanoparticles for PET imaging of sentinel lymph node metastasis

“…Tumor metastasis is one of the main causes of tumor-related death [ 1 , 2 ]. Sentinel lymph node (SLN) is the first lymph node that tumor drainage reaches [ 3–5 ].…”

Construction of model animals to explore intestinal microbiome for detection of breast cancer

“…However, in the early stage of breast cancer, the cure ratio of patients with active treatment can reach more than 90%, and there is no need for chemotherapy, radiotherapy, and other operations. But in the late stage, the cancer cells could spread through lymphatic metastasis, blood metastasis, implantation metastasis, direct metastasis, and other ways, and eventually appear as systemic multi-organ lesions, directly threatening the life of patients [ 6 – 9 ]. There are no effective measures to prevent breast cancer.…”