Axillary web syndrome assessment using a self-assessment questionnaire: a prospective cohort study

Abstract

Our findings indicated that the incidence of AWS is high in breast cancer patients, particularly in the first month after surgery. Not all patients achieved recovery during our 8 week follow-up, suggesting that evaluation and treatment should be longer. Double AWS detection was found for patients who were younger (age < 50) and with normal weight.

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

“…Two recent careful prospective studies that included evaluations of postoperative breast cancer patients demonstrated that the actual value may lie somewhere between these two extremes. One study had a prevalence of AWS of 50% at 18 months,2 and the other had a 51% incidence in the 8 weeks11 following surgery. The incidence is higher in surgery with ALND (36%–72%)1,2,4,7,9,10 compared with surgery with sentinel lymph node biopsy (SNB) (11%–58%) 1,4,7,10.…”

“…For reasons that are not clear, the incidence of AWS is highest in patients who have a prior or contemporaneous contralateral prophylactic mastectomy (86%) 2. The incidence is also higher in patients who have a lower body mass index,1,10,12 who are younger age,1,8,10,11 who have more education,11 who exercise more frequently,11 who have a greater number of lymph nodes removed,1,7 who receive more extensive surgery,1,7,11 or who receive adjunctive chemotherapy7 or radiation therapy 7…”

“…AWS is usually diagnosed 2–8 weeks following breast cancer surgery 2,3,6,7. A recent prospective study11 suggested that 94% of patients who developed AWS diagnosed it within the first 4 weeks using a self-assessment tool. Another prospective study13 found that careful practitioner evaluation was able to detect 66% of AWS cases within 7 days of surgery.…”

“…Location and intensity of pain should be assessed during upper extremity movements since tension on the cord occurs during movement especially shoulder abduction. The Disabilities of the Arm, Shoulder, and Hand questionnaire has been frequently used to assess upper extremity shoulder function in individuals with AWS1,2,7,20,22 but other questionnaires may also be useful to assess pain, function, and/or quality of life in individuals with AWS 2,7,11,20. Lymphedema assessment is also warranted1,2,7,8,15,20 using available measuring methods such as girth measurements, perometer, bioimpedance, and/or tissue dielectric constant.…”

Chronic axillary web syndrome: 83 months post lumpectomy-A Case report

“…A recent prospective study suggested that 94% of patients who developed AWS diagnosed it within the fi rst month. However, there are some reports showing that AWS may appear or persist well beyond that 12-week window to as late as 2 years after axillary surgery [3]. The incidence is higher in surgery with axillary clearance (36%-72%), compared with surgery with sentinel lymph node biopsy (11%-58%) [4].…”