Function, Shoulder Motion, Pain, and Lymphedema in Breast Cancer With and Without Axillary Web Syndrome: An 18-Month Follow-Up

Koehler, Linda A; Hunter, David W.; Blaes, Anne; Haddad, Tufia C.

doi:10.1093/ptj/pzy010

Cited by 51 publications

(65 citation statements)

References 27 publications

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“…AWS most commonly develops 2–8 weeks following breast cancer surgery 1–4,7. However, recent studies have shown that AWS can occur months to years later and can also resolve and then relapse 2,7…”

Section: Introductionmentioning

confidence: 99%

“…One study had a prevalence of AWS of 50% at 18 months,2 and the other had a 51% incidence in the 8 weeks11 following surgery. The incidence is higher in surgery with ALND (36%–72%)1,2,4,7,9,10 compared with surgery with sentinel lymph node biopsy (SNB) (11%–58%) 1,4,7,10. For reasons that are not clear, the incidence of AWS is highest in patients who have a prior or contemporaneous contralateral prophylactic mastectomy (86%) 2.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Axillary web syndrome following breast cancer surgery: symptoms, complications, and management strategies

Koehler¹,

Haddad²,

Hunter³

et al. 2018

BCTT

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Axillary web syndrome (AWS) is a common condition occurring in up to 86% of patients following breast cancer surgery with ipsilateral lymphadenectomy of one or more nodes. AWS presents as a single cord or multiple thin cords in the subcutaneous tissues of the ipsilateral axilla. The cords may extend variable distances “down” the ipsilateral arm and/or chest wall. The cords frequently result in painful shoulder abduction and limited shoulder range of motion. AWS most frequently becomes symptomatic between 2 and 8 weeks postoperatively but can also develop and recur months to years after surgery. Education about and increased awareness of AWS should be promoted for patients and caregivers. Assessments for AWS should be performed on a regular basis following breast cancer surgery especially if there has been associated lymphadenectomy. Physical therapy, which consists of manual therapy, exercise, education, and other rehabilitation modalities to improve range of motion and decrease pain, is recommended in the treatment of AWS.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Axillary web syndrome following breast cancer surgery: symptoms, complications, and management strategies

Koehler¹,

Haddad²,

Hunter³

et al. 2018

BCTT

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“…Complicating things further, depending upon the extent of tissue removal and damage from the surgery [1,12,14] and radiation treatment [9,13,20,21] multiple fascial slings [17] may have been disrupted, creating a ripple effect on biomechanics of the entire body, reaching far beyond the shoulder. To date, there has been very little attention focused on soft tissue alterations [5,6,10,15] which are more likely to be the causative origin of joint dysfunctions. We propose these soft tissue changes can create systemic shifts in patient function due to effects on the fascial slings, resulting in altered length tension relationships in muscle-tendon complexes with negative implications in proprioception as joint loading is secondarily affected possibly disrupting the entire nervous system.…”

Section: Functional Limitations and Dysfunctional Presentationsmentioning

confidence: 99%

Tensegrity: A Novel Conceptual Framework for Rehabilitation of Functional Deficits for Breast Cancer Survivors

King

Battaglini

2019

J. of SCI. IN SPORT AND EXERCISE

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The current approach to breast cancer rehabilitation is currently narrowly focused on addressing resultant problems such as lymphedema or shoulder pain. Referrals to rehabilitation are reactive responses to these problems. Taking a step back and looking at the breast cancer intervention in totality, it becomes apparent that steps could be taken to minimize or actually prevent some of the ensuing functional problems by proactively treating a breast cancer survivor. Rather than waiting for problems to arise, immediately post-intervention or ideally pre-intervention and throughout intervention referral of an individual to rehabilitation could provide a supportive role in the functional progression of the patient. Furthermore, while most orthopedic rehabilitation focuses on the function of a particular joint, with the extensive impact of the breast cancer treatments on the soft tissue of the body without any specific intervention at a joint, it is imperative that we begin to shift our rehabilitation approach to focusing on the alterations of the soft tissue prior to addressing any functional limitations in the joints, with the most common victim being the shoulder joint. This novel approach to breast cancer rehabilitation suggests initially addressing soft tissue limitations. As these limitations begin to resolve as optimally as possible, secondary consideration is then given to functional limitations of a joint such as the shoulder joint.

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“…These patients can be treated more conservatively with similar outcomes, but without complications, commonly accompanying radical surgery (Huang et al, 2016, Choi et al, 2018. A complete axillary lymph node dissection in combination with a damage of lymphatic vasculature frequently results in lymphedema or axillary web syndrome, conditions which are potentially mutilating and can lead to disability (Gillespie et al, 2018, Koehler et al, 2018. Highly advantageous is that sentinel lymph node biopsy has a widespread application in the management of multiple oncological conditions, though in our review paper, we focus specifi cally on invasive breast cancer.…”

Section: Introductionmentioning

confidence: 99%

Sentinel lymph node – historical background and current views on its significance in complex management of breast cancer patients

Kubikova¹,

Badidova²,

Klein³

et al. 2019

BLL

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Nowadays, breast cancer is the leading oncological diagnosis in women worldwide. On the other hand, breast cancer treatment can be considered one of the most progressive therapeutic approach in the medical fi eld of oncology. The invasive types of breast cancer have a tendency to spread via lymphatic route, what brings in the issue of sentinel lymph node-the fi rst node into which the lymph drains from a given anatomical location. This review paper discusses the historical background of the concept of sentinel lymph node and focuses on clinical signifi cance of the positivity of sentinel lymph node(s) as well. Modern-day conservative therapeutic surgery of breast cancer should be in accordance with diagnostic and preventive interventions in the axilla, whose rate of invasiveness and morbidity must be also attenuated without worsening the patient´s prognosis and survival rate. Formerly, a complete axillary lymph node dissection was routinely performed for prophylactic and cancer staging purposes. The indiscriminate application of this approach was replaced by sentinel lymph node biopsy. Along with common histopathological examination, immunohistochemistry, as well as modern techniques of molecular biology are often employed. These state-of-the-art methods enabled the identifi cation of micrometastases, or even nanometastases, though their real prognostic value is yet to be concluded (Ref. 52).

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Function, Shoulder Motion, Pain, and Lymphedema in Breast Cancer With and Without Axillary Web Syndrome: An 18-Month Follow-Up

Cited by 51 publications

References 27 publications

Axillary web syndrome following breast cancer surgery: symptoms, complications, and management strategies

Axillary web syndrome following breast cancer surgery: symptoms, complications, and management strategies

Tensegrity: A Novel Conceptual Framework for Rehabilitation of Functional Deficits for Breast Cancer Survivors

Sentinel lymph node – historical background and current views on its significance in complex management of breast cancer patients

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