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Axillary web syndrome following breast cancer surgery: symptoms, complications, and management strategies

Authors Koehler LA, Haddad TC, Hunter DW, Tuttle TM

Received 21 April 2018

Accepted for publication 11 October 2018

Published 20 December 2018 Volume 2019:11 Pages 13—19

DOI https://doi.org/10.2147/BCTT.S146635

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Pranela Rameshwar


LA Koehler,1–3 TC Haddad,4 DW Hunter,5 TM Tuttle3,6

1Division of Physical Therapy, 2Division of Rehabilitation Medicine, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, USA; 3University of Minnesota, Masonic Cancer Center, Minneapolis, MN, USA; 4Mayo Clinic, Division of Medical Oncology, Department of Oncology, Rochester, MN, USA; 5Department of Radiology, Medical School, University of Minnesota, Minneapolis, MN, USA; 6Department of Surgery, Medical School, University of Minnesota, Minneapolis, MN, USA

Abstract: Axillary web syndrome (AWS) is a common condition occurring in up to 86% of patients following breast cancer surgery with ipsilateral lymphadenectomy of one or more nodes. AWS presents as a single cord or multiple thin cords in the subcutaneous tissues of the ipsilateral axilla. The cords may extend variable distances “down” the ipsilateral arm and/or chest wall. The cords frequently result in painful shoulder abduction and limited shoulder range of motion. AWS most frequently becomes symptomatic between 2 and 8 weeks postoperatively but can also develop and recur months to years after surgery. Education about and increased awareness of AWS should be promoted for patients and caregivers. Assessments for AWS should be performed on a regular basis following breast cancer surgery especially if there has been associated lymphadenectomy. Physical therapy, which consists of manual therapy, exercise, education, and other rehabilitation modalities to improve range of motion and decrease pain, is recommended in the treatment of AWS.

Keywords: cording, Mondor’s disease, rehabilitation, axillary lymphadenectomy

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