DIRECT LYMPHOGRAPHY OF THE BREAST

Abstract

The surgical treatment of breast cancer has been developed on the basis of the topographic anatomy of lymphatic vessels and regional lymph nodes. The axillary and infraclavicular lymph nodes of the breast as well as their afferent lymphatic vessels and the pectoral muscles are removed in continuity. Provided that the lymphatic anatomy of the patient is normal, the operation seems to be radical indeed: yet recurrences and late metastases are often observed (8).

In the diagnosis of regional lymph nodes palpation has remained the most common method of examination. However, axillary palpation is not suitable for the demonstration of the collateral lymphatic system developing as a result of blocked main lymphatic channels by tumour deposits. Examination of the axillary lymph nodes by palpation gives according to data in the literature (6, 9, 10) an incorrect diagnosis in about 30 per cent of cases. More accurate methods of examination with regard to diagnosis, prognosis, and therapy are needed to be chosen. With more accurate examinations patients who seem operable according to the classical methods of investigation, but who already have metastases outside the field of operation, can be selected. In order to come closer to the "correct diagnosis" we used direct lymphography of the breast in a group of patients with breast cancer. In recent related literature two authors had reported of similar investigations. Lewis (7) performed successful lymphangioadenography at two patients with benign tumour of the breast, while Halsell (5) studied the anatomy of
mammary lymphatics by the method of lymphangiography, also in 7 benign cases.