Many women complain that they have decreased flexibility in their arm after breast cancer surgery. In fact, a new study reveals that approximately 40% of patients will have axillary web syndrome after sentinel lymph node biopsy and up to 70% of patients after axillary lymph node dissection.
What is AWS?
AWS is characterized by the appearance, palpation of, or sensation of, a pulling down the arm on the side from which lymph nodes were removed. The cord may appear as one or multiple strings that extend from the armpit, or axilla, as far down the arm to the thumb in some cases.
AWS is associated with decreased shoulder flexibility (especially when raising the arm out to the side away from the body towards overhead), a lower BMI (body mass index), a higher number of lymph nodes removed, and overall decreased long term function.
It is thought to be associated to damage sustained by the lymphatic system and less likely, to the venous system. AWS can be present immediately after surgery, or it can present later. It can be present, then disappear only to reappear months later.
Linda Koehler, PhD, PT, was the leading author of this study, and an expert on AWS at The University of Minnesota.