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Related Experiment Videos

Axillary web syndrome after axillary dissection.

A H Moskovitz1, B O Anderson, R S Yeung

  • 1Department of Surgery, Surgical Oncology Section, Bio-Clinical Breast Care Program, University of Washington, Box 356410, 1959 NE Pacific Street, Seattle, WA 98195, USA.

American Journal of Surgery
|July 13, 2001
PubMed
Summary

Axillary web syndrome (AWS) causes pain and limited motion after surgery, appearing as tissue webs. This condition is self-limiting, resolving within months, but may occur even after less invasive procedures.

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Area of Science:

  • Oncology
  • Surgical Pathology
  • Lymphedema Research

Background:

  • Post-axillary lymph node dissection (ALND) complications include pain and restricted shoulder movement.
  • A palpable web of tissue extending from the axilla into the arm is often associated with these symptoms.
  • This previously undescribed condition is termed axillary web syndrome (AWS).

Purpose of the Study:

  • To characterize the clinical presentation and pathology of axillary web syndrome (AWS).
  • To identify the incidence and risk factors associated with AWS following breast cancer surgery.

Main Methods:

  • Retrospective review of invasive breast cancer patients treated between 1980 and 1996.
  • Inclusion of 4 recent patients who developed AWS after sentinel node lymph node dissection (SLND) without ALND.

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  • Histopathological analysis of tissue samples from AWS webs.

    • Main Results:

    • 44 out of 750 patients (6%) developed AWS 1-8 weeks post-axillary procedure.
    • AWS presented as subcutaneous cords causing pain and limiting shoulder abduction to <= 90 degrees in 74% of cases.
    • Tissue analysis revealed lymphatic and venous channel occlusion; AWS resolved within 2-3 months and also occurred after SLND.

    Conclusions:

    • Axillary web syndrome is a self-limiting cause of early postoperative morbidity.
    • Minimizing lymphovenous disruption during axillary surgery may reduce AWS incidence and severity.
    • Sentinel node lymph node dissection does not entirely prevent the occurrence of AWS.