The upper‐limb volumetric changes in breast cancer survivors with axillary web syndrome

• Published in: European journal of cancer care Vol. 26; no. 2; pp. e12637 - n/a
• Main Authors: Huang, H.‐C., Liu, H.‐H., Yin, L.‐Y., Yeh, C.‐H., Tu, C.‐W., Yang, C.‐S.
• Format: Journal Article
• Language: English
• Published: England Hindawi Limited 01.03.2017
• Subjects: Active control; Adult; Anthropometry; arm volume; Axilla; axillary web syndrome; Biopsy; Breast cancer; breast cancer rehabilitation; Breast Neoplasms - surgery; Cancer; Circumferences; Diagnostic software; Diagnostic systems; Dissection; Education; Elbow; Elbow (anatomy); Female; Hand Strength; Humans; Incidence; Intervention; Lymph; Lymph Node Excision; Lymph nodes; Lymphatic system; Lymphedema; Lymphedema - epidemiology; Middle Aged; Morbidity; Muscle Strength - physiology; Nursing; Organ Size; Pain; Patients; Postoperative Complications - epidemiology; Quality of Life; Range of Motion, Articular - physiology; Shoulder; Shoulder Joint - physiopathology; Surgery; Surgical instruments; Swelling; Syndrome; Upper Extremity - pathology; Upper Extremity - physiopathology; arm volume; axillary web syndrome; lymphedema; breast cancer rehabilitation
• ISSN: 0961-5423; 1365-2354
• DOI: 10.1111/ecc.12637

Whether upper‐limb swelling is associated with axillary web syndrome (AWS) is unknown. We recruited unilateral breast cancer (BC) patients who were scheduled for surgical intervention and lymph node dissection. The pre‐operative assessment and post‐operative assessment 3–4 weeks after surgery evaluated the upper‐limb circumferential measurements, segmental limb volume, pain scores, grasp, shoulder range of motion (ROM), shoulder muscle power and quality‐of‐life scores. In the control group, the peri‐elbow volume and upper‐arm volume were significantly higher post‐operatively than pre‐operatively. In the AWS group, no significant difference was found. In comparison with the control group, the AWS group had significantly more pain, less active ROM in shoulder abduction and a lower upper‐limb volume at 0–10 cm proximal to the lateral epicondyle. The incidence of lymphedema was 9.9% and was not associated with AWS. AWS is a common morbidity of lymph node dissection and causes significant pain and restricted shoulder abduction in the affected limb in BC survivors. This study is the first to investigate post‐operative upper‐limb volumetric changes in BC survivors with and without AWS. Our findings are of great value for the clinical effect of AWS in BC survivors, for patient education, and for developing diagnostic tools for detecting AWS.