Article

Axillary web syndrome (AWS) is a condition that may develop following
breast cancer surgery and that presents as a palpable axillary cord of tissue.
The purposes of this study were: (1) to determine the clinical
characteristics of AWS related to movement, function, pain, and postoperative
edema and (2) to define the incidence of and risk factors for AWS within the
first 3 months following breast cancer surgery. DESIGN:
This was a prospective
cohort study with a repeated-measures design. METHODS: Women who underwent breast
cancer surgery with sentinel node biopsy or axillary lymph node dissection (N=36)
were assessed for AWS, shoulder range of motion, function, pain, and
postoperative edema (using girth measurements, bioimpedance, and tissue
dielectric constant) at 2, 4, and 12 weeks. Demographic characteristics were used
for risk analysis. RESULTS: Seventeen women (47.2%) developed AWS, and AWS
persisted in 10 participants (27.8%) at 12 weeks. Abduction range of motion was
significantly lower in the AWS group compared with the non-AWS group at 2 and 4
weeks. There were no differences between groups in measurements of function,
pain, or edema at any time point. Trunk edema measured by dielectric constant was
present in both groups, with an incidence of 55%. Multivariate analysis
determined lower body mass index as being significantly associated with AWS (odds
ratio=0.86; 95% confidence interval=0.74, 1.00). LIMITATIONS: Limitations
included a short follow-up time and a small sample size. CONCLUSION: Axillary web
syndrome is prevalent following breast/axilla surgery for early-stage breast
cancer and may persist beyond 12 weeks. The early consequences include movement
restriction, but the long-term effects of persistent AWS cords are yet unknown.
Low body mass index is considered a risk factor for AWS.
CI - (c) 2015 American Physical Therapy Association.

Langue : ANGLAIS