Thanks so much for your efforts to obtain an answer to my question on 8/21. I must confess to being more confused than ever. If your Surgical Colleagues feel that the information I provided is not consistent with what actually happens with a mastectomy, is there any way you can educate me on where I have gone wrong in my thinking? My assumptions to this point have been: Prior to Mastectomy the breast has a blood supply. During surgery the blood vessels serving the breast are severed, ligated or electrocauterized. I was wondering what effect this has on the severed blood vessels. They basically become "dead ends", don't they, and are they subject to forming scar tissue and becoming hardened? Also, prior to Mastectomy, lymph drains from the breast to the lymph nodes, usually at the lowest level(1) first. Surgery severs the ducts leading from the breast to the lymph nodes (which are left behind when no axillary dissection or sentinel node procedure is performed). My main question is - what happens to the lymph nodes closest to the mastectomy site when the breast is no longer draining into them? Is it possible they might respond by becoming enlarged and/or hardened?
I guess I was just curious to know if Surgeons had observed any of these sorts of scarrings in their mastectomy patients upon examination 6 months to a year after surgery?
Are these totally unreasonable questions?
Dear PG, When a blood vessel or lymph node is tied off or cauterized, the end does not usually become enlarged or hardened. A blood vessel is not just a straight tube it branches off, much like a river has tributaries that feed into it. If the river is blocked the flow of water will find other ways to go, likewise when a blood vessel or lymph node is blocked off blood and lymph fluid diverts to other branches of the system to vascularize (take blood to)other areas. So there is not a pooling or build up of fluid at the cauterized ends, the fluid is diverted to other surrounding tissues and structures by way of the "branching" of the vessels.
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