Spread
Direct local extension:
- to the skin and subcutaneous tissue producing dimpling, nipple retraction
Lymphatic regional spread:
- superior - to supraclavicular nodes
- medial - to internal mammary nodes
- lateral - to axillary nodes, which are divided into:
- level I - laterally to the lateral border of pectoralis minor
- level II - behind pectoralis minor
- level III - medial to pectoralis minor
Haematogenous to distant sites:
- bone, pleura and lungs, liver
- brain, ovaries, contralateral breast
Transcoloemic spread to distant sites:
- pleural and peritoneal seeding in advanced disease
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