Breast Lymphatics

Breast tissue consists of milk-producing cells and fat cells within fascial compartments called lobes (and their smaller division, lobules). Each lobe has tiny arterial and venous pathways which deliver fresh blood to the area, and transport or drain blood and its constituents back toward the heart. Optimal breast health depends largely on the ability of blood and lymph fluid to move freely throughout the area. 

Lymphatic fluid is part of both the circulatory system (providing a way for blood to return to the heart) and the immune system (circulating immune cells that help prevent infection and illness). Anywhere there is blood, there is lymph. In fact, there is anywhere from 2 to 4 times as much lymph in the body as blood. Just like blood, lymph falls into the category of liquid fascia, or liquid connective tissue, because it flows almost everywhere in the body. It is found in the interstitial space that surrounds tissue cells. Once the fluid has entered the smallest unit of the lymphatic system, the lymphatic capillary, it is called lymph.

Generally speaking, lymph has two very important functions. First, lymph transports protein molecules which are unable to re-enter the bloodstream via blood capillaries. A healthy lymphatic system helps prevent swelling by moving protein molecules and their bonded water molecules out of the interstitial space and into the lymphatic capillaries. Second, lymph assists in circulating foreign bodies and pathogenic substances (germs, toxins, etc.) through the lymphatic system so that they can be broken down and purified by lymph nodes, preventing infection and illness.

Lymph fluid is found in all areas of the breast – from the superficial surface just beneath the skin, to the microscopic space around the lobules. A key to breast health is getting the fluid from the interstitial spaces into the lymphatic capillaries and moving toward the lymph nodes for filtration and processing. Many things can impede the movement of lymph, such as post-surgical scar tissue, tight undergarments, even tight muscles or fascia.

Breast health can be improved by manual therapies that assist in the movement of fluid through the lymphatic system. There is no muscle tissue within the breast itself, so breastwork should be conceptualized as breast drainage rather than breast massage. The goal of therapy is to drain the fluid from the breast to the nearest lymph nodes: the axillary and parasternal nodes. Around three-quarters of breast lymph moves toward lymph nodes in the armpit (axillary nodes). Most of the remaining lymph drains toward the sternum (parasternal nodes).

Lymphatic breast care may be sought by women experiencing breast pain related to pregnancy and/or breastfeeding, as a pre/post-surgical intervention, or in the treatment of pre-menstrual symptoms. The treatment should be painless, as only a light amount of pressure is used to facilitate the movement of lymph. The therapist will begin the treatment by opening the lymph nodes surrounding the breast, before draining lymph from within the breast itself. Treatment can be performed overtop of clothing or a sheet, as per the client’s comfort. One treatment may be enough to reduce pain associated with swollen breasts, but treatment outcomes vary.

Written by Breanne Hamper, October 2021