Identification of Signs and Symptoms of Axillary Web Syndrome and Breast Seroma During a Course of Physical Therapy 7 Months After Lumpectomy: A Case Report

Abstract

Background and Purpose Axillary web syndrome (AWS) and seroma are common and function-limiting side effects following treatments for breast cancer. Studies of AWS and seroma are rare, and there are no guidelines for physical therapy in these cases. Case Description After left breast lumpectomy due to invasive ductal carcinoma, a 65-year-old female patient underwent intraoperative radiation therapy and whole breast radiation. Seven months later, during treatment for breast swelling, AWS and breast seroma were identified by a physical therapist certified in lymphedema treatment. Treatment goals were to reduce breast swelling and pain and to improve shoulder movements. Interventions included manual lymph drainage, left arm stretching, and instruction about self–lymphatic-drainage and stretching exercise. Also, a compression bra was ordered, and continued daily activities and physical activity were recommended. Outcomes Improvement in shoulder movement, breast swelling, and pain. Discussion Because evidence for treatment guidelines following treatments for breast cancer is lacking, close follow-up for treatment-related complications is recommended. Management should be chosen according to signs and symptoms. Realistic expectations can reduce patient frustration and improve coping strategies and compliance with self-treatment demands. Clinical studies to support these conclusions are required.

Effectiveness of an Adapted Physical Activity Protocol for Upper Extremity Recovery and Quality of Life Improvement in a Case of Seroma after Breast Cancer Treatment

“…Traumatic aspiration may increase the incidence of surgical site infection, clinic visit, and mental stress of patients [8]. While recent research supports that physical activity (PA) interventions can improve physical functioning, treatment-related symptoms, and QoL in cancer survivors [3,5,10,11], the possible effectiveness of PA in cases developing seroma has yet to be demonstrated [12]. Therefore, we herein evaluated for the first time the possible effects of a structured PA pathway for upper extremity recovery and QoL improvement in a case of peri-prosthetic seroma after BC treatment.…”

Axillary Web Syndrome in Breast Cancer Women: What Is the Optimal Rehabilitation Strategy after Surgery? A Systematic Review

“…As a result, 11 studies were included in the present work [13,[31][32][33][34][35][36][37][38][39][40].…”

“…The studies included were two (18.2%) RCTs [31,32], one (9.1%) non-RCT [33], one (9.1%) retrospective observational study [34], and seven (63.6%) case reports [13,[35][36][37][38][39][40].…”

Effect of physical activity levels on oncological breast surgery recovery: a prospective cohort study

“…In this study, we found an association between vigorous PA performance and risk of developing AWS. The authors who previously examined risk factors for developing AWS found no relationship between training level and increased risk of AWS 47 , 48 , with the exception of a case report that described AWS development after physical effort 49 . Moreover, among the risk factors for the development of AWS should be considered younger age, greater time elapsed since surgery and number of resected lymph nodes 50 , but PA was not considered.…”