Mondor's Disease of the Axilla: A Rare Complication of Sentinel Node Biopsy

Pappo, Itzhak; Wasserman, Ilan; Stahl-Kent, Varda; Sandbank, Judith; Halevy, Ariel

doi:10.1111/j.1075-122x.2004.21438.x

Cited by 22 publications

(17 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Menezes et al [12] observed that 85.7% of patients with limited range of motion have AWS, and Moskovitz et al [13] verified that 74% of the patients who showed AWS had joint restriction. These divergent results in the literature could be because of the different methodological designs because most articles about AWS are case reports [6,7,10,[14][15][16][17] or retrospectives studies [12,13,18] where the identification of AWS may have induced the symptoms. In this study, all women were subjected at palpation and examination of the affected arm independent of the symptoms reported.…”

Section: Discussionmentioning

confidence: 99%

“…The axillary web syndrome (AWS) had been one of the complications that takes place between the fifth and eighth weeks and is characterized by palpable cords in the breast, underarm, medial arm, antecubital space, forearm, or abdominal wall and is clinically associated with pain and limited shoulder range of motion [4][5][6][7]. After SLNB, the incidence of AWS was reported by 20% of women and, after AL, varies considerably between 38 and 72% [5,8,9].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence and risk factors for axillary web syndrome after breast cancer surgery

Bergmann

Mendes

Dias

et al. 2011

Breast Cancer Res Treat

View full text Add to dashboard Cite

The objective of the study is to estimate the incidence and risk factors of axillary web syndrome (AWS) in early postoperative period (45 days). From the prospective cohort of women undergoing breast cancer surgery, we collected the variables related to patient characteristics, treatment, tumor, and postoperative complications. We performed bivariate and logistic regression. A total of 193 patients are included with a mean age of 58.26 years, majority of which are women who are overweight or obese (72.3%). The incidence of AWS was 28.1%. The presence of pain in the ipsilateral upper-limb associated with AWS was reported in 5.4% of the patients, and the shoulder joint restriction was observed in 11.4%. When controlling for confounding between AWS and the factors that showed statistical significance in bivariate analysis, the variables that explain the occurrence of the AWS were the type of axillary surgery, where women who underwent sentinel lymph node biopsy showed 68% less risk compared with those that underwent axillary lymphadenectomy (AL) (RR = 0.32; 95% CI, 0.13-0.79; P value = 0.014) and numbness in the arm after an injury of the intercostobrachial nerve, which is 3.19 times the risk of the AWS (RR = 3.19; 95% CI, 1.40-7.29, P value = 0.006). From the above findings, we concluded that the incidence of AWS was 28.1%, and it was associated with AL and numbness in the arm after injury of the intercostobrachial nerve.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors for axillary web syndrome after breast cancer surgery

Bergmann

Mendes

Dias

et al. 2011

Breast Cancer Res Treat

View full text Add to dashboard Cite

show abstract

Section: Presentation (65 Weeks After Mastectomy)mentioning

confidence: 99%

“…(5,8,11,19,(23)(24)(25)(26) No standard of care has been established for the prevention or treatment of AWS. Manual therapies including myofascial release, scar massage, and lymphatic drainage techniques, as well as physical therapy, thermal therapy, surgery, and oral agents (anti-inflammatories and antibiotics (26) ) have been reviewed in detail by Yeung et al (8) Manual methods and physical therapy usually involve conservative treatment in several sessions over weeks or even months, with varying degrees of success in symptom reduction and cord resolution. (8,15,(18)(19)(23)(24)(25)27) Manual axial distraction with firm digital pressure applied at various points to rupture the cord (usually at the first session) successfully relieved pain and movement limitations in a series of patients, (12) but, as with most prospective studies and case reports, any negative consequences for healing and particularly for risk of lymphedema were not investigated.…”

Section: Presentation (65 Weeks After Mastectomy)mentioning

confidence: 99%

Dynamic Angular Petrissage as Treatment for Axillary Web Syndrome Occurring after Surgery for Breast Cancer: a Case Report

Lewis¹,

Cunningham²

2016

IJTMB

View full text Add to dashboard Cite

Background: In the context of breast cancer, axillary web syndrome (AWS), also called lymphatic cording, typically presents in the weeks after axillary surgery. This painful condition, likely lymphofibrotic in origin, restricts upper extremity range of motion (ROM). There is no established treatment, although physical therapy and other approaches have been used to variable effect. This report describes treatment of a female client with AWS, who had recently undergone a unilateral simple mastectomy with sentinel node biopsy plus axillary dissection.Methods: The client presented with pain upon movement (self-reported as 5 on the 0-10 Oxford Pain Scale), visible cording and restricted use of the ipsilateral upper extremity. Clinical assessment included determining the extent of AWS cording (taut, from axilla to wrist) and measuring glenohumeral joint ROM (140° flexion by goniometer). A therapeutic massage with movement protocol, termed dynamic angular petrissage, was administered over two sessions: Swedish massage combined with dynamically taking the limb through all possible angles of movement (passive ROM), controlling stretch and tension while simultaneously and segmentally applying petrissage and non-petrissage techniques to the underlying soft tissue. Careful attention was taken to not break the cord. Home care consisted of prescribed exercises performed by the patient.Results: After Session One, pain was reduced (to 0/10), ROM improved (to 170° flexion), and cording was visibly reduced. After Session Two the cord was residually apparent only on hyperextension, with no ROM restrictions in glenohumeral joint flexion. Follow-up at three months revealed absence of visual or palpable evidence of cording, unrestricted glenohumeral joint ROM, and absence of movement-associated pain.Conclusion: The signs and symptoms of AWS were quickly and effectively eliminated, without causing any pain or discomfort to the client. We propose that dynamic angular petrissage may be an efficient and safe treatment approach for reducing the pain, mobility restrictions, and cording of AWS.

show abstract

“…ondor's disease is a peculiar form of superficial thrombophlebitis that affects the subcutaneous vein, mainly of the anterolateral thoraco-abdominal wall 1,2) or rarely of other parts including axilla 3) and cervical region. 4) It usually occurs as a sudden, subcutaneous pain, and palpable and visible subcutaneous cord-like indurations.…”

mentioning

confidence: 99%

Mondor’s Disease in the Arm after Intravenous Chemotherapy Following Breast Cancer Surgery

Hasegawa

Okita

2010

Annals of Vascular Diseases

View full text Add to dashboard Cite

We present a case of superficial thrombophlebitis of the arm, known as a variant of Mondor's disease. A 71-year-old woman who underwent a left simple mastectomy with axillary dissection for breast cancer had a cord-like vein structure in the right antecubital fossa following postoperative intravenous chemotherapy, and complained of limited elbow extension due to the firm and inflexible structure. She successfully underwent surgical resection of the vein cord to relieve the elbow motion limitation.

show abstract

Mondor's Disease of the Axilla: A Rare Complication of Sentinel Node Biopsy

Cited by 22 publications

References 17 publications

Incidence and risk factors for axillary web syndrome after breast cancer surgery

Incidence and risk factors for axillary web syndrome after breast cancer surgery

Dynamic Angular Petrissage as Treatment for Axillary Web Syndrome Occurring after Surgery for Breast Cancer: a Case Report

Mondor’s Disease in the Arm after Intravenous Chemotherapy Following Breast Cancer Surgery

Contact Info

Product

Resources

About