Axillary Web Syndrome

  • Axillary web syndrome:
    • Appears to be a common complication following axillary surgery
    • It consists of the appearance of a visible web of axillary skin overlying palpable cords of tissue:
      • That are made taut and painful by shoulder abduction
    • These cords can result in painful abduction of the shoulder and reduced range of motion
    • It typically results from axillary lymphadenectomies for treatment of breast cancer or melanoma
  • In general, axillary web syndrome is poorly defined and misunderstood:
    • In a large systematic review:
      • The incidence ranged from 0.6% to 85.4%
    • Risk factors:
      • Extent of surgery (number of nodes removed)
      • Low body mass index
      • Age
    • Although smoking, receipt of neoadjuvant chemotherapy, and radiation may play a role in its development:
      • These factors have not been described in the literature
  • In the majority of cases, axillary web syndrome:
    • Appears to develop within 2 to 8 weeks of axillary surgery
  • Although patients generally do well with resolution of their symptoms:
    • Current evidence for the treatment of axillary web syndrome is insufficient to provide clear guidance for clinical practice
    • Suggested interventions have included:
      • Early education
      • Physiotherapy
      • Thermal therapy
      • Medications
      • Surgery
  • References
  • Koehler LA, Haddad TC, Hunter DW, Tuttle TM. Axillary web syndrome following breast cancer surgery: symptoms, complications and management strategies. Breast Cancer. 2018;11:13-19.
  • Yeung WM, McPhail SM, Kuys SS. A systematic review of axillary web syndrome (AWS). J Cancer Surviv. 2015;9(4):576-598

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