The upper‐limb volumetric changes in breast cancer survivors with axillary web syndrome
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 evalua...
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Published in | European journal of cancer care Vol. 26; no. 2; pp. e12637 - n/a |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
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Hindawi Limited
01.03.2017
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Abstract | 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. |
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AbstractList | 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. 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. |
Author | Yang, C.‐S. Huang, H.‐C. Yin, L.‐Y. Liu, H.‐H. Yeh, C.‐H. Tu, C.‐W. |
Author_xml | – sequence: 1 givenname: H.‐C. surname: Huang fullname: Huang, H.‐C. organization: Ditmanson Medical Foundation Chia‐Yi Christian Hospital – sequence: 2 givenname: H.‐H. surname: Liu fullname: Liu, H.‐H. organization: Ditmanson Medical Foundation Chia‐Yi Christian Hospital – sequence: 3 givenname: L.‐Y. surname: Yin fullname: Yin, L.‐Y. organization: Ditmanson Medical Foundation Chia‐Yi Christian Hospital – sequence: 4 givenname: C.‐H. surname: Yeh fullname: Yeh, C.‐H. organization: Ditmanson Medical Foundation Chia‐Yi Christian Hospital – sequence: 5 givenname: C.‐W. surname: Tu fullname: Tu, C.‐W. organization: Ditmanson Medical Foundation Chia‐Yi Christian Hospital – sequence: 6 givenname: C.‐S. surname: Yang fullname: Yang, C.‐S. email: 02150@cych.org.tw organization: Ditmanson Medical Foundation Chia‐Yi Christian Hospital |
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Cites_doi | 10.1016/S0002-9610(01)00602-X 10.1016/j.breast.2014.09.001 10.1097/PPO.0b013e31817fbe5e 10.1016/S1470-2045(08)70179-7 10.1007/s10549-009-0371-8 10.1016/j.arr.2013.07.003 10.1016/j.ijrobp.2011.05.043 10.1159/000337210 10.1007/s10549-011-1805-7 10.1097/01.prs.0000277995.25009.3e 10.1093/ptj/86.2.205 10.1093/ptj/83.2.134 10.1007/s11764-015-0435-1 10.1016/S0002-9610(02)01214-X 10.1159/000145384 10.1006/jsre.2000.6021 |
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Keywords | arm volume axillary web syndrome lymphedema breast cancer rehabilitation |
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References | 2012; 131 2006; 86 2001; 164 2012 2013; 46 2001; 181 2013; 12 2009b 2011; 81 2009a 2007; 120 2008; 9 2008; 14 2008; 3 2012; 224 2003; 83 2015; 9 2001; 95 2014; 23 2003; 185 2009; 117 Harris (10.1111/ecc.12637-BIB0004|ecc12637-cit-0004) 2001; 164 International Society of Lymphology (10.1111/ecc.12637-BIB0005|ecc12637-cit-0005) 2013; 46 10.1111/ecc.12637-BIB0018|ecc12637-cit-0018 Leidenius (10.1111/ecc.12637-BIB0008|ecc12637-cit-0008) 2003; 185 Aydogan (10.1111/ecc.12637-BIB0001|ecc12637-cit-0001) 2008; 3 Zuther (10.1111/ecc.12637-BIB0021|ecc12637-cit-0021) 2009b Moskovitz (10.1111/ecc.12637-BIB0009|ecc12637-cit-0009) 2001; 181 Wall (10.1111/ecc.12637-BIB0017|ecc12637-cit-0017) 2013; 12 Sclafani (10.1111/ecc.12637-BIB0012|ecc12637-cit-0012) 2008; 14 Zuther (10.1111/ecc.12637-BIB0020|ecc12637-cit-0020) 2009a Shah (10.1111/ecc.12637-BIB0013|ecc12637-cit-0013) 2011; 81 Nevola Teixeira (10.1111/ecc.12637-BIB0010|ecc12637-cit-0010) 2014; 23 Yeung (10.1111/ecc.12637-BIB0019|ecc12637-cit-0019) 2015; 9 Coleman (10.1111/ecc.12637-BIB0003|ecc12637-cit-0003) 2008; 9 Kosir (10.1111/ecc.12637-BIB0007|ecc12637-cit-0007) 2001; 95 Torres Lacomba (10.1111/ecc.12637-BIB0016|ecc12637-cit-0016) 2009; 117 Karges (10.1111/ecc.12637-BIB0006|ecc12637-cit-0006) 2003; 83 Bergmann (10.1111/ecc.12637-BIB0002|ecc12637-cit-0002) 2012; 131 Suami (10.1111/ecc.12637-BIB0014|ecc12637-cit-0014) 2007; 120 Rashtak (10.1111/ecc.12637-BIB0011|ecc12637-cit-0011) 2012; 224 Taylor (10.1111/ecc.12637-BIB0015|ecc12637-cit-0015) 2006; 86 |
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10.1111/ecc.12637-BIB0016|ecc12637-cit-0016 article-title: Axillary web syndrome after axillary dissection in breast cancer: A prospective study publication-title: Breast Cancer Research and Treatment doi: 10.1007/s10549-009-0371-8 contributor: fullname: Torres Lacomba – volume: 12 start-page: 898 year: 2013 ident: 10.1111/ecc.12637-BIB0017|ecc12637-cit-0017 article-title: Skeletal muscle atrophy during short-term disuse: Implications for age-related sarcopenia publication-title: Ageing Research Reviews doi: 10.1016/j.arr.2013.07.003 contributor: fullname: Wall – start-page: 48 volume-title: Lymphedema management: The comprehensive guide for practitioners year: 2009b ident: 10.1111/ecc.12637-BIB0021|ecc12637-cit-0021 contributor: fullname: Zuther – volume: 81 start-page: 907 year: 2011 ident: 10.1111/ecc.12637-BIB0013|ecc12637-cit-0013 article-title: Breast cancer-related arm lymphedema: Incidence rates, diagnostic techniques, optimal management and risk reduction strategies publication-title: International Journal of Radiation Oncology Biology Physics doi: 10.1016/j.ijrobp.2011.05.043 contributor: fullname: Shah – volume: 224 start-page: 110 year: 2012 ident: 10.1111/ecc.12637-BIB0011|ecc12637-cit-0011 article-title: From furuncle to axillary web syndrome: Shedding light on histopathology and pathogenesis publication-title: Dermatology doi: 10.1159/000337210 contributor: fullname: Rashtak – volume: 131 start-page: 987 year: 2012 ident: 10.1111/ecc.12637-BIB0002|ecc12637-cit-0002 article-title: Incidence and risk factors for axillary web syndrome after breast cancer surgery publication-title: Breast Cancer Research and Treatment doi: 10.1007/s10549-011-1805-7 contributor: fullname: Bergmann – volume: 164 start-page: 191 year: 2001 ident: 10.1111/ecc.12637-BIB0004|ecc12637-cit-0004 article-title: Clinical practice guidelines for the care and treatment of breast cancer: 11. Lymphedema publication-title: CMAJ contributor: fullname: Harris – volume: 120 start-page: 982 year: 2007 ident: 10.1111/ecc.12637-BIB0014|ecc12637-cit-0014 article-title: Changes in the lymph structure of the upper limb after axillary dissection: Radiographic and anatomical study in a human cadaver publication-title: Plastic and Reconstructive Surgery doi: 10.1097/01.prs.0000277995.25009.3e contributor: fullname: Suami – volume: 86 start-page: 205 year: 2006 ident: 10.1111/ecc.12637-BIB0015|ecc12637-cit-0015 article-title: Reliability and validity of arm volume measurements for assessment of lymphedema publication-title: Physical Therapy doi: 10.1093/ptj/86.2.205 contributor: fullname: Taylor – volume: 46 start-page: 1 year: 2013 ident: 10.1111/ecc.12637-BIB0005|ecc12637-cit-0005 article-title: The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology publication-title: Lymphology contributor: fullname: International Society of Lymphology – volume: 83 start-page: 134 year: 2003 ident: 10.1111/ecc.12637-BIB0006|ecc12637-cit-0006 article-title: Concurrent validity of upper-extremity volume estimates: Comparison of calculated volume derived from girth measurements and water displacement volume publication-title: Physical Therapy doi: 10.1093/ptj/83.2.134 contributor: fullname: Karges – volume: 9 start-page: 576 year: 2015 ident: 10.1111/ecc.12637-BIB0019|ecc12637-cit-0019 article-title: A systematic review of axillary web syndrome (AWS) publication-title: Journal of Cancer Survivorship doi: 10.1007/s11764-015-0435-1 contributor: fullname: Yeung – volume: 185 start-page: 127 year: 2003 ident: 10.1111/ecc.12637-BIB0008|ecc12637-cit-0008 article-title: Motion restriction and axillary web syndrome after sentinel node biopsy and axillary clearance in breast cancer publication-title: American Journal of Surgery doi: 10.1016/S0002-9610(02)01214-X contributor: fullname: Leidenius – volume: 3 start-page: 277 year: 2008 ident: 10.1111/ecc.12637-BIB0001|ecc12637-cit-0001 article-title: Axillary web syndrome after sentinel node biopsy publication-title: Breast Care (Basel) doi: 10.1159/000145384 contributor: fullname: Aydogan – volume: 95 start-page: 147 year: 2001 ident: 10.1111/ecc.12637-BIB0007|ecc12637-cit-0007 article-title: Surgical outcomes after breast cancer surgery: Measuring acute lymphedema publication-title: Journal of Surgical Research doi: 10.1006/jsre.2000.6021 contributor: fullname: Kosir |
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Snippet | Whether upper‐limb swelling is associated with axillary web syndrome (AWS) is unknown. We recruited unilateral breast cancer (BC) patients who were scheduled... Whether upper-limb swelling is associated with axillary web syndrome (AWS) is unknown. We recruited unilateral breast cancer (BC) patients who were scheduled... |
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SubjectTerms | 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 |
Title | The upper‐limb volumetric changes in breast cancer survivors with axillary web syndrome |
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