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Characterizing axillary web syndrome: ultrasonographic efficacy.

L A Koehler, D W Hunter, T C Haddad

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    |April 29, 2015
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    Summary

    High-frequency ultrasound could not identify axillary web syndrome (AWS) structures in breast cancer patients. This suggests AWS may involve subtle changes like microlymphatic stasis, not visible with current ultrasound technology.

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    Area of Science:

    • Medical Imaging
    • Oncology
    • Vascular Biology

    Background:

    • Axillary web syndrome (AWS) can cause discomfort and limited arm mobility post-breast cancer surgery.
    • The exact pathophysiological basis of AWS remains unclear, with theories including vascular, lymphatic, or structural abnormalities.

    Purpose of the Study:

    • To investigate the utility of high-frequency ultrasound in characterizing AWS.
    • To elucidate the underlying pathophysiology of AWS as a vascular, lymphatic, or structural issue.

    Main Methods:

    • A prospective study involving 17 women with AWS post-breast cancer surgery.
    • High-resolution (18 MHz) ultrasound imaging of affected axillary cords compared to contralateral sides.
    • Blinded radiologist assessment of ultrasound characteristics and structural changes.

    Main Results:

    • Ultrasound failed to identify any distinct structure or abnormality consistent with AWS.
    • No significant statistical differences were found in skin thickness, subcutaneous tissue characteristics, or echodensity between affected and unaffected sides.
    • A blinded radiologist correctly identified the AWS side in only 12 out of 17 subjects.

    Conclusions:

    • 18 MHz ultrasound is insufficient to detect specific structural abnormalities in AWS.
    • Findings suggest AWS is not caused by vein thrombosis or fascial abnormalities.
    • The results support theories implicating non-visible pathologies like microlymphatic stasis or interstitial protein binding.