Cording: a treatable complication of breast cancer surgery

Smith, Chani

doi:10.3399/bjgp19x704825

Cited by 3 publications

(4 citation statements)

References 2 publications

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“…Recent studies indicate that AWS can develop as well as recur within months to years after surgery [ 5 , 8 , 39 ]. The reported incidence of AWS varies widely, from 6 to 86%, partly due to misdiagnosis and confusion with scar tissue [ 8 , 39 , 40 ].…”

Section: Lymphovascularmentioning

confidence: 99%

“…Although the pathogenesis is unclear, cording is believed to be caused by lymphatic vessel and tissue damage during procedures like SLNB and ALND, commonly performed alongside mastectomy [ 5 , 40 ]. ALND surgeries have a higher incidence of cording (36%-72%) compared to SLNB surgeries (11%-58%), and patients with a prior or concurrent mastectomy are at the highest risk of developing AWS [ 39 ].…”

Section: Lymphovascularmentioning

confidence: 99%

“…Physical therapy plays a crucial role in AWS treatment, focusing on exercises to improve flexibility, strength, ROM, and abduction of the affected limb [ 41 ]. Licensed practitioners provide in-clinic treatments including myofascial release, soft tissue mobilization, cord manipulation, and stretching while the arm is abducted, specifically focusing on softening the cord [ 40 , 41 ]. During soft tissue mobilization, it is not uncommon for cords to spontaneously break [ 5 ].…”

Section: Lymphovascularmentioning

confidence: 99%

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Postmastectomy Functional Impairments

Marco,

Trépanier,

Chang

et al. 2023

Curr Oncol Rep

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Purpose of Review This narrative review aims to offer a thorough summary of functional impairments commonly encountered by breast cancer survivors following mastectomy. Its objective is to discuss the factors influencing these impairments and explore diverse strategies for managing them. Recent Findings Postmastectomy functional impairments can be grouped into three categories: neuromuscular, musculoskeletal, and lymphovascular. Neuromuscular issues include postmastectomy pain syndrome (PMPS) and phantom breast syndrome (PBS). Musculoskeletal problems encompass myofascial pain syndrome and adhesive capsulitis. Lymphovascular dysfunctions include lymphedema and axillary web syndrome (AWS). Factors such as age, surgical techniques, and adjuvant therapies influence the development of these functional impairments. Summary Managing functional impairments requires a comprehensive approach involving physical therapy, pharmacologic therapy, exercise, and surgical treatment when indicated. It is important to identify the risk factors associated with these conditions to tailor interventions accordingly. The impact of breast reconstruction on these impairments remains uncertain, with mixed results reported in the literature.

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Section: Lymphovascularmentioning

confidence: 99%

Section: Lymphovascularmentioning

confidence: 99%

Section: Lymphovascularmentioning

confidence: 99%

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Postmastectomy Functional Impairments

Marco,

Trépanier,

Chang

et al. 2023

Curr Oncol Rep

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“…1,4 Sometimes these symptoms are the first sign of cording, even before the cord is visible. 5 AWS is seen as a complication of breast cancer and melanoma surgery, including sentinel node biopsy and axillary lymphadenectomy. 3 The prevalence of AWS secondary to breast cancer surgery varies widely with studies reporting rates ranging from 6% to 85.4%.…”

Section: Introductionmentioning

confidence: 99%

Refractory Axillary Web Syndrome Successfully Treated with Steroid Injections: A Case Report

Munayco Maldonado,

Adepoju

2023

Arch Breast Cancer

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Background: Axillary Web Syndrome (AWS) manifests after breast cancer surgery as 1mm wide, singular, or multiple cords that can extend from the ipsilateral axilla to the antecubital fossa and further into the forearm and wrist. These cords can be painful and cause diminished range of motion. Even though there is no current standard treatment for AWS, physical therapy is recommended as the first approach in management. In refractory cases, no management has been proposed. Case Presentation: We present a case of a 59-year-old female with right-sided breast pain and a palpable cord, refractory to one year of physical therapy, which began at the inframammary fold up towards the lumpectomy scar and further towards the axilla. Cord developed post-lumpectomy and post-radiation for a right-sided stage I invasive ductal carcinoma with negative sentinel lymph node biopsy. Based on the refractory nature of the cord, the patient underwent three treatments of steroid injections which made the cord less palpable and improved the pain. Due to persistent diminished range of motion and tenderness, the patient underwent a percutaneous needle cord disruption procedure with a last round of corticosteroid injection to prevent adherence of the cord pieces. At a 7-month follow up post-procedure, the breast cord was no longer present, and range of motion had been restored. Conclusion: We found that percutaneous cord disruption with concurrent steroid injections can be an effective treatment for AWS refractory to physical therapy.

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George

2023

InnovAiT: Education and inspiration for general practice

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Cording: a treatable complication of breast cancer surgery

Cited by 3 publications

References 2 publications

Postmastectomy Functional Impairments

Postmastectomy Functional Impairments

Refractory Axillary Web Syndrome Successfully Treated with Steroid Injections: A Case Report

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