Skip to main content

Advertisement

SpringerLink
Log in

Incidence and risk factors for axillary web syndrome after breast cancer surgery

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

The objective of the study is to estimate the incidence and risk factors of axillary web syndrome (AWS) in early postoperative period (45 days). From the prospective cohort of women undergoing breast cancer surgery, we collected the variables related to patient characteristics, treatment, tumor, and postoperative complications. We performed bivariate and logistic regression. A total of 193 patients are included with a mean age of 58.26 years, majority of which are women who are overweight or obese (72.3%). The incidence of AWS was 28.1%. The presence of pain in the ipsilateral upper-limb associated with AWS was reported in 5.4% of the patients, and the shoulder joint restriction was observed in 11.4%. When controlling for confounding between AWS and the factors that showed statistical significance in bivariate analysis, the variables that explain the occurrence of the AWS were the type of axillary surgery, where women who underwent sentinel lymph node biopsy showed 68% less risk compared with those that underwent axillary lymphadenectomy (AL) (RR = 0.32; 95% CI, 0.13−0.79; P value = 0.014) and numbness in the arm after an injury of the intercostobrachial nerve, which is 3.19 times the risk of the AWS (RR = 3.19; 95% CI, 1.40−7.29, P value = 0.006). From the above findings, we concluded that the incidence of AWS was 28.1%, and it was associated with AL and numbness in the arm after injury of the intercostobrachial nerve.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61(2):69–90

    Article  PubMed  Google Scholar 

  2. Morrow M (2010) Trends in the surgical treatment of breast cancer. Breast J 16(Suppl 1):S17–S19

    Article  PubMed  Google Scholar 

  3. Kootstra JJ, Hoekstra-Weebers JE, Rietman JS, de Vries J, Baas PC, Geertzen JH, Hoekstra HJ (2010) A longitudinal comparison of arm morbidity in stage I-II breast cancer patients treated with sentinel lymph node biopsy, sentinel lymph node biopsy followed by completion lymph node dissection, or axillary lymph node dissection. Ann Surg Oncol 17(9):2384–2394

    Article  PubMed  Google Scholar 

  4. Leduc O, Sichere M, Moreau A, Rigolet J, Tinlot A, Darc S, Wilputte F, Strapart J, Parijs T, Clement A, Snoeck T, Pastouret F, Leduc A (2009) Axillary web syndrome: nature and localization. Lymphology 42(4):176–181

    PubMed  CAS  Google Scholar 

  5. Leidenius M, Leppanen E, Krogerus L, von Smitten K (2003) Motion restriction and axillary web syndrome after sentinel node biopsy and axillary clearance in breast cancer. Am J Surg 185(2):127–130

    Article  PubMed  Google Scholar 

  6. Rezende LFF, Franco RL, Gurgel MSC (2005) Axillary web syndrome: practical implications. Breast J 11(6):531

    Article  Google Scholar 

  7. Pappo I, Wasserman I, Stahl-Kent V, Sandbank J, Halevy A (2004) Mondor’s disease of the axilla: a rare complication of sentinel node biopsy. Breast J 10(3):253–255

    Article  PubMed  Google Scholar 

  8. Bergmann A, Mattos IE, Koifman RJ, Ribeiro MJ, Nogueira EA, Ribeiro EP, Marchon RM, Maia AV, Roberto DR, Pereira TB, Santos IV, Viana FV, Magno J, Gonçalo AC (2007) Axillary web syndrome after lymph node dissection: preliminary results of 1004 breast cancer patients. Lymphology 40(Suppl):198–203

    Google Scholar 

  9. Torres Lacomba MT, Mayoral Del Moral O, Coperias Zazo JL, Yuste Sanchez MJ, Ferrandez JC, Zapico Goni A (2009) Axillary web syndrome after axillary dissection in breast cancer: a prospective study. Breast Cancer Res Treat 117(3):625–630

    Article  PubMed  Google Scholar 

  10. Fourie WJ, Robb KA (2009) Physiotherapy management of axillary web syndrome following breast cancer treatment: discussing the use of soft tissue techniques. Physiotherapy 95(4):314–320

    Article  PubMed  CAS  Google Scholar 

  11. Bergmann A, Ribeiro MJP, Pedrosa E, Nogueira EA, Oliveira ACG (2006) Fisioterapia em mastologia oncológica: rotinas do Hospital do Câncer III/INCA. Rev Bras Cancerol 52(11):97–109

    Google Scholar 

  12. Menezes AG, Sampaio EA, Carvalho CC (2008) Perfil das pacientes pós-cirurgia de câncer de mama com síndrome do cordão axilar. Rev Bras Mastol 18(2):48–53

    Google Scholar 

  13. Moskovitz AH, Anderson BO, Yeung RS, Byrd DR, Lawton TJ, Moe RE (2001) Axillary web syndrome after axillary dissection. Am J Surg 181(5):434–439

    Article  PubMed  CAS  Google Scholar 

  14. Franco RL, Rezende LF, Gurgel MSC (2005) Axillary web syndrome. Rev Bras Mastol 15(4):182–185

    Google Scholar 

  15. Tilley A, Thomas-Maclean R, Kwan W (2009) Lymphatic cording or axillary web syndrome after breast cancer surgery. Can J Surg 52(4):E105–E106

    PubMed  Google Scholar 

  16. Reedijk M, Boerner S, Ghazarian D, McCready D (2006) A case of axillary web syndrome with subcutaneous nodules following axillary surgery. Breast 15(3):411–413

    Article  PubMed  Google Scholar 

  17. Villamiel EC, Alcover AR, Rodriguez IM (2008) Axillary web syndrome. Prog Obstet Ginecol 51(12):745–748

    Article  Google Scholar 

  18. Aydogan F, Belli AK, Baghaki S, Karabulut K, Tahan G, Uras C (2008) Axillary web syndrome after sentinel node biopsy. Breast Care (Basel) 3(4):277–278

    Article  Google Scholar 

Download references

Acknowledgments

The authors declare that this manuscripts comply with the current laws of Brasil and the study was approved by the research ethics committee of the National Cancer Institute/INCA. This article did not receive any grant support.

Conflict of interest

No potential and real conflicts of interest.

Author information

Authors and Affiliations

  1. Augusto Motta University Center, Av. Paris, 72 - Bonsucesso, Rio de Janeiro, RJ, 21041-020, Brazil

    Anke Bergmann, Valéria Vasconcellos Mendes, Ricardo de Almeida Dias & Blenda do Amaral e Silva

  2. National Cancer Institute, Rua Visconde de Santa Izabel, 274, Rio de Janeiro, RJ, 20560-120, Brazil

    Anke Bergmann, Valéria Vasconcellos Mendes, Ricardo de Almeida Dias, Blenda do Amaral e Silva, Maria Giseli da Costa Leite Ferreira & Erica Alves Nogueira Fabro

Authors
  1. Anke Bergmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Valéria Vasconcellos Mendes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ricardo de Almeida Dias
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Blenda do Amaral e Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Maria Giseli da Costa Leite Ferreira
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Erica Alves Nogueira Fabro
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anke Bergmann.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bergmann, A., Mendes, V.V., de Almeida Dias, R. et al. Incidence and risk factors for axillary web syndrome after breast cancer surgery. Breast Cancer Res Treat 131, 987–992 (2012). https://doi.org/10.1007/s10549-011-1805-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-011-1805-7

Keywords

Search

Navigation