Axillary Ganglia: What are they? Location, Function and its Relationship in Breast Cancer

Mistakenly called lymphatic glands, they are part of the lymphatic system, a component of the body’s immune system.

When the lymph nodes become swollen it can be indicative of an infection. The lymph nodes are small nodes formed by soft tissue that are shaped like beans.

The lymph nodes that can be felt when enlarged or swollen are the chain of lymph nodes found on the front, side, and back of the neck, behind the ears, under the chin, in the armpits, and in the groin.

There is also a large group of lymph nodes in the chest and abdomen, which can be seen enlarged when X-rays or CT scans are done.

Location of the axillary nodes

The body has about 20 to 40 lymph nodes. They are about 1 cm in size.

The axillary nodes are divided into five groups according to their arrangement:

  1. Subscapular axon (posterior).
  2. Apical (medial o subclavicular).
  3. Pectoral axillary (anterior).
  4. Brachial (lateral).
  5. Central lymph node.

The subscapular axillary lymph nodes are located in the lower part of the back wall of the armpit.

The axillary ganglia were divided by Berg into three anatomical “levels”: level I, lateral and inferior to the border of the pectoralis minor muscle, level II, below the pectoralis minor muscle; and level III (also called infraclavicular nodules), medial and superior to the border of the pectoralis minor muscle.

The apical and pectoral ganglia are located respectively in the upper and lower parts of the pectoralis minor, a thin, flat muscle of the thorax.

The brachial ganglia are located in relation to the medial and posterior parts of the axillary vein.

The central axillary lymph nodes are found within the fatty tissue near the base of the armpit.

Function

The lymphatic system is made up of lymph nodes and ducts and lymphatic vessels, located throughout the body.

This immune system carries the tissue fluid that surrounds cells and contains white blood cells (lymphocytes), fluid from the intestines (chyle), and some red blood cells through the veins.

Lymph nodes act as filters for the lymphatic system, eliminating harmful substances in the body.

Lymph is the extracellular fluid that circulates throughout the body and cleanses blood vessels and tissues.

Lymph enters and drains through the lymph nodes, where white blood cells (lymphocytes) produce antibodies that are protein particles that bind to foreign substances, including infectious corpuscles and macrophages that attack and destroy tumor cells and pathogens. .

After filtration, the lymph is returned to the bloodstream for circulation as blood plasma.

Thus, the axillary nodes drain the upper limb, chest wall, and upper lateral abdominal wall, and localized axillary lymphadenopathy represents a response to a pyogenic infection of the upper limb.

Lymph nodes in breast cancer

Breast cancer initially develops as a lump in the breast, but it often spreads to the axillary lymph nodes, allowing it to access the lymphatic system and travel to other areas of the body.

During surgical procedures to remove breast cancer, including lumpectomies and partial, radical, or total mastectomies, surgeons often remove some of the axillary lymph nodes to determine whether the breast cancer has spread and also to determine staging. cancer.

The axillary nodes drain the ipsilateral arm, sinus, and chest wall. To examine these nodules, the physician must ensure that the patient’s axillary skin is relaxed by first supporting and adducting the patient’s arm.

The nodes are located on the posterior, anterior or medial walls of the axillary fossa or at its apex.

Efferent lymphatic vessels travel directly to the systemic veins at the root of the neck, although a few efferent vessels pass first through the ipsilateral supraclavicular nodes.

During breast removal surgery, if cancer has spread to the axillary lymph nodes, they are often removed by surgeons to study the extent of the cancer.

The number of positive nodes is of prognostic significance. This is a key variable in patients with early stage breast carcinoma.

Patients in the early stages of breast cancer have a 30-40% chance of having positive axillary nodes.

Lymph nodes can indicate the presence and absence of tumor cells and are one of the key indicators of the type of treatment that each individual patient requires.

Lymph node removal helps in the removal of cancer cells from the nodes, which greatly prevents cancer metastasis .

The cancer recurrence rate after axillary dissection was shown to be less than 2%.