The subscapular vein accompanies the subscapular artery, draining the subscapularis muscle, teres major, and latissimus dorsi into the axillary vein. It is the largest tributary of the axillary vein and receives the thoracodorsal vein and circumflex scapular vein.
The subscapular vein is encountered during axillary lymph node dissection and in lateral chest wall approaches. The thoracodorsal pedicle (thoracodorsal artery and its venous companion) drains into the subscapular vein — this junction must be identified and preserved in latissimus dorsi flap surgery. In axillary clearance, the subscapular vein is retracted medially to preserve the thoracodorsal nerve.
Inadvertent injury to the subscapular vein or thoracodorsal venous junction during axillary node dissection producing significant axillary haemorrhage and potentially devascularising a planned latissimus flap.
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