Question

A woman with breast cancer subsequently develops metastases in her vertebral column. The most direct route for spread of the tumor to the vertebral column was via:

A. branches of the cephalic vein
B. branches of the lateral thoracic vein
C. branches of the thoracoacromial veins
D. lymphatic vessels draining into the axilla
E. branches of the intercostal veins

Answer 1

The most direct route for breast cancer metastasis to the vertebral column is through the vertebral veins, which drain into the brachiocephalic vein and communicate with the intercostal veins.

Step-by-step explanation:

The most direct route for the spread of breast cancer to the vertebral column is via the vertebral vein. This vein arises from the base of the brain and the cervical region of the spinal cord, then passes through the intervertebral foramina in the cervical vertebrae, draining smaller veins from the cranium, spinal cord, and vertebrae.

It eventually leads to the brachiocephalic vein, which is connected to the superior vena cava that drains most of the body superior to the diaphragm. Given the options provided, the correct answer to the route of metastasis would be the branches of the intercostal veins (Option E), which are likely to communicate with the vertebral venous system.