Axillary web syndrome and its associations with lymphedema and movement amplitude deficit in women submitted to breast cancer surgery

Cross-sectional study

Abstract

Introduction: Breast cancer is the most frequent neoplasm in Brazilian women and control of post treatment morbidities has stimulated investigations for a better quality of life. Objectives: To determine the frequency of axillary web syndrome (AWS) and the association with lymphedema and range of motion (MAD) of the  shoulder joint after axillary surgery. Methods: Between December 2011 and September 2012, 97 women surgically treated for breast cancer were enrolled at the Cancer Hospital of Pernambuco, Brazil. The search for axillary cords, goniometry of the shoulder joint and perimetry of the ipsilateral and contralateral upper limbs of the affected breast were performed. For comparison between goniometric and perimetric values, Student's t-test and Lévené variance analysis were used. Chi-square and Fisher's exact tests were used to compare proportions. The significance level p ≤ 0.05 was adopted. The work was approved by Human Research Ethics Committee. Results: AWS was diagnosed in 28 (28.86%) women, of whom 15 (53.57%) had lymphedema. There was a significant reduction in most movements in the ipsilateral limb compared to its contralateral limb. Conclusions: There were
expressive numbers of women diagnosed with AWS and association with early onset of perimetry changes, in addition to a significant reduction in shoulder range of motion.