title: Movement, Function, Pain, and Postoperative Edema in Axillary Web Syndrome.
abstract: BACKGROUND
  Axillary web syndrome (AWS) is a condition that may develop following breast cancer surgery and that presents as a palpable axillary cord of tissue.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  Limitations included a short follow-up time and a small sample size.
  
  
  CONCLUSIONS
  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.
authors.affiliation: L.A. Koehler, PT, PhD, CLT-LANA, Program in Physical Therapy, Physical Medicine and Rehabilitation Department and Masonic Cancer Center, University of Minnesota Medical School, Mayo Mail Code 388, 420 Delaware St SE, Minneapolis, MN 55455 (USA). koeh0139@umn.edu.
authors.forename: Linda A
authors.initials: LA
authors.lastname: Koehler
authors.affiliation: A.H. Blaes, MD, Department of Hematology/Oncology and Masonic Cancer Center, University of Minnesota.
authors.forename: Anne H
authors.initials: AH
authors.lastname: Blaes
authors.affiliation: T.C. Haddad, MD, Department of Oncology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Tuffia C
authors.initials: TC
authors.lastname: Haddad
authors.affiliation: D.W. Hunter, MD, Department of Radiology, University of Minnesota.
authors.forename: David W
authors.initials: DW
authors.lastname: Hunter
authors.affiliation: A.T. Hirsch, MD, Medicine Cardiology Division, University of Minnesota.
authors.forename: Alan T
authors.initials: AT
authors.lastname: Hirsch
authors.affiliation: P.M. Ludewig, PT, PhD, Program in Physical Therapy, Physical Medicine and Rehabilitation Department, University of Minnesota Medical School.
authors.forename: Paula M
authors.initials: PM
authors.lastname: Ludewig
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000601:surgery*; D015331:Cohort Studies; D004487:Edema / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D015994:Incidence; D008197:Lymph Node Excision / Q000009:adverse effects*; D008408:Mastectomy / Q000009:adverse effects*; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012307:Risk Factors; D012782:Shoulder; D013577:Syndrome; D013997:Time Factors