Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy.
Museum of Human Anatomy "Filippo Civinini", University of Pisa, 56126 Pisa, Italy.
Medicina (Kaunas). 2021 Nov 19;57(11):1272. doi: 10.3390/medicina57111272.
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.
乳腺癌是导致女性过早死亡的重要原因之一，也是全球最常见的肿瘤之一。因此，为了提高患者的生活质量，对其进行常规筛查以预防和早期诊断至关重要。乳腺癌细胞可以进入血液和淋巴毛细血管，然后转移到腋窝的区域淋巴结以及内脏和非内脏部位。它们似乎主要通过前哨淋巴结进入体循环，而不是原发部位，并且对这个指标的活检可以影响在外科手术治疗病理学时进行的腋窝解剖。此外，继发性淋巴水肿是乳腺癌手术后或放疗后女性的另一个重要问题。考虑到这些基本方面，本文旨在描述评估腋窝区域淋巴管解剖结构的新方法，以及淋巴血管功能的分子和生理控制，以了解淋巴系统如何促进乳腺癌的发展。由于其具有临床意义，还研究了控制乳腺癌淋巴结转移的分子机制。除了对乳腺淋巴管网络和淋巴分子机制的研究外，发现新的有效的抗淋巴管生成药物用于未来的临床环境对于支持乳腺癌治疗的任何未来发展都显得至关重要。
