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

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Abstract

Background

Surgical procedure for breast cancer is not without its side effects and one such side effect is axillary web syndrome (AWS), characterized by palpable fibrotic-like cords in the operated arm. As physical evaluation is the only gold standard method used, our study aims to assess the incidence and early detection of AWS with a self-assessment questionnaire.

Methods

From July 2013 to July 2014, 370 breast cancer patients were enrolled. AWS incidence was 51.1%, with 94.1% onset in the first 4 weeks after surgery; 43.5% of the patients did not recover in the first 8 weeks. Univariate analysis showed that BMI (P < 0.001), age (P < 0.001), educational level (P = 0.01), and exercise frequency in the eighth week of follow-up (P < 0.001) were significantly associated with the AWS detection, and multivariate analyses confirmed that younger patients (age < 50) have significantly higher AWS detection (OR = 2.38 (95%CI 1.53, 3.71) and that BMI is associated with AWS, with normal weight patients (BMI ≤ 25) having a significantly greater AWS detection with an odds ratio of 2.11 (95%CI 1.33, 3.36).

Conclusion

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.

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Acknowledgments

We would like to thank the Umberto Veronesi Foundation for the scholarship grant to the author Colpani D. and William Samuel Edu Russell for the help with the grammatical corrections.

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Authors and Affiliations

  1. Physiotherapy Department, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy

    F. Baggi, Luiz Felipe Nevola Teixeira, M. C. Simoncini, E. Bonacossa, F. Sandrin, M. Sciotto Marotta, G. Lanni, P. Dadda & D. Colpani

  2. Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy

    S. Gandini

  3. Breast Surgery Unit, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy

    A. Luini

Authors
  1. F. Baggi
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  2. Luiz Felipe Nevola Teixeira
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  3. S. Gandini
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  4. M. C. Simoncini
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  7. M. Sciotto Marotta
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  10. D. Colpani
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  11. A. Luini
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Contributions

All authors make substantial contributions to conception and design, and/or acquisition of data, and/or analysis and interpretation of data; participate in drafting the article or revising it critically for important intellectual content; and gave final approval of the version to be submitted and any revised version.

Study conception and design: B.F., N.T.L.F., S.M.C., and L.A.

Acquisition of data: B.F., N.T.L.F., B.E., S.F., S.M.M., L.G., and D.P. C.D.

Analysis and interpretation of data: G.S.

Drafting of manuscript: B.F., N.T.L.F., S.M.C., and G.S.

Critical revision: B.F., N.T.L.F., G.S., S.M.C., B.E., S.F., S.M.M., L.G., D.P. C.D., and L.A.

Corresponding author

Correspondence to Luiz Felipe Nevola Teixeira.

Ethics declarations

The study was approved by the ethical review board of the European Institute of Oncology.

Conflict of interest

The authors declare that they have no conflict of interest.

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Baggi, F., Nevola Teixeira, L.F., Gandini, S. et al. Axillary web syndrome assessment using a self-assessment questionnaire: a prospective cohort study. Support Care Cancer 26, 2801–2807 (2018). https://doi.org/10.1007/s00520-018-4123-3

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  • DOI: https://doi.org/10.1007/s00520-018-4123-3

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