Sappey plexus
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At the time the article was created Stefano Pacifici had no recorded disclosures.
View Stefano Pacifici's current disclosuresAt the time the article was last revised Daniel J Bell had no recorded disclosures.
View Daniel J Bell's current disclosures- Sappey's subareolar plexus
- Sappey's plexus
Sappey plexus is a network of lymphatics in the areola of the nipple. Sappey plexus assumes considerable importance in the identification of the sentinel lymph node since the subareolar route is the most straightforward to infiltrate with an injected radiotracer/dye and the most suitable in special cases, such as non-palpable tumors, multicentric or already excised tumors.
Gross anatomy
The breast originates from ectodermal tissue, thus its lymphatic drainage is mostly parallel to the lymph flow of the overlying skin. Lymphatic flow from the skin finds its way to the diffuse subcutaneous plexus between the skin and the superficial fascia. Each lobule of the breast has an extensive lymphatic plexus, that come together to form the Sappey subareolar plexus. The Sappey subareolar plexus and deep fascial plexus are in connection with each other through fibrous strands traversing the breast tissue. All the lymphatics of the breast converge to form the Sappey plexus.
History and etymology
Sappey plexus takes its name from Marie Philibert Constant Sappey (1810-1896) 7, a French anatomist who published his comprehensive atlas in 1874, including an anatomic study of cutaneous lymphatic drainage. Sappey's results demonstrated lymphatic drainage based on anatomic location.
References
- 1. Kumar R, Bozkurt MF, Zhuang H et-al. Sentinel lymph node biopsy in the management of breast cancer. Indian J Cancer. 40 (2): 60-6. Indian J Cancer (link) - Pubmed citation
- 2. Suami H, Pan WR, Mann GB et-al. The lymphatic anatomy of the breast and its implications for sentinel lymph node biopsy: a human cadaver study. Ann. Surg. Oncol. 2008;15 (3): 863-71. doi:10.1245/s10434-007-9709-9 - Free text at pubmed - Pubmed citation
- 3. Olivier JB, Verhaeghe JL, Butarelli M et-al. [Functional anatomy of the lymphatic drainage of the breast: contribution of sentinel lymph node biopsy]. Ann Chir. 2006;131 (10): 608-15. doi:10.1016/j.anchir.2006.06.011 - Pubmed citation
- 4. Forbis P, Stedman TL, Bartolucci SL. Stedman's medical eponyms. Lippincott Williams & Wilkins. (1998) ISBN:0683079654. Read it at Google Books - Find it at Amazon
- 5. Forbes G. Lymphatics of the Skin, with a Note on Lymphatic Watershed Areas. J. Anat. 1938;72 (Pt 3): 399-410. - Free text at pubmed - Pubmed citation
- 6. Modena S. Trattato di senologia. Piccin-Nuova Libraria. (2006) ISBN:8829918091. Read it at Google Books - Find it at Amazon
- 7. Arvy L, Rivet R. [Marie Philibert Constant Sappey (1810-1896). The man and the lymphologist]. (1976) Bulletin de l'Association des anatomistes. 60 (168): 63-79. Pubmed
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