A patient undergoes axillary lymph node dissection for breast cancer. She subsequently develops lymphedema. The pathophysiological mechanism of breast cancer-related lymphedema primarily involves:

• A Obstruction of thoracic duct causing chyle reflux
• B Disruption of axillary lymphatic channels with failure of lymphangiogenesis ✓
• C Venous thrombosis of axillary vein with secondary lymphatic insufficiency
• D Increased capillary permeability from radiation-induced cytokines

Explanation

Breast cancer-related lymphedema (BCRL) results primarily from disruption and fibrosis of axillary lymphatic channels following surgery and/or radiation, combined with failure of compensatory lymphangiogenesis. The damaged lymphatics cannot adequately drain protein-rich interstitial fluid, leading to accumulation and chronic inflammation with fibroadipose tissue deposition. Thoracic duct is not primarily involved. Axillary vein thrombosis may contribute but is not the primary mechanism. Radiation exacerbates lymphedema by inducing fibrosis in residual lymphatics.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.