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Spread

Authoring team

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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