Lymphedema following a mastectomy is due to: Question 5 options: Surgical removal of lymph nodes Proliferation of regional lymph nodes Atrophy of lymph nodes Sclerosis or scarring of lymph nodes
Lymphedema following a mastectomy is due to:
Question 5 options:
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Surgical removal of lymph nodes |
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Proliferation of regional lymph nodes |
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Atrophy of lymph nodes |
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Sclerosis or scarring of lymph nodes |
I. Definition of Lymphedema
Lymphedema is defined as pathological interstitial edema resulting from inadequate lymphatic drainage. It is characterized by swelling in the interstitial tissues between cells.
II. Etiology of Post-Surgical Lymphedema
Lymphedema most usually occurs after following modified radical mastectomy (MRM) which is for breast cancer treatment. MRM involves total excision of the breast parenchyma and overlying skin, with Level I-II axillary lymphadenectomy.
III. Pathogenesis of Lymphedema following MRM
Resection of axillary lymph nodes during MRM disrupts the normal flow of lymph from the upper extremities through efferent lymphatic vessels. This impairs the lymphatic system's ability to drain excess interstitial fluid from the arm and breast via remaining lymphatics.
IV. Pathological Fluid Accumulation
Without adequate egress of lymph through excised lymph nodes, interstitial fluid accumulates in the soft subcutaneous tissues of the arm and breast.
V. Progression and Treatment
The degree of lymphedema ranges from mild to severe based on volume of interstitial fluid accumulation. It may resolve transiently or progress to long-term lymphedema requiring lifelong management. Standard treatments include compression garments, manual lymph drainage, and complete decongestive therapy to reduce swelling and prevent exacerbations.
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