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Axillary Web Syndrome: Current Understanding and New Directions for Treatment.

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    This summary is machine-generated.

    Axillary web syndrome (AWS) treatment improved with new methods. Percutaneous cord disruption and Xiaflex injection offer effective options for painful post-breast cancer surgery scar tissue, enhancing mobility and reducing pain.

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    Area of Science:

    • Oncology
    • Plastic Surgery
    • Physical Medicine and Rehabilitation

    Background:

    • Axillary web syndrome (AWS) is a common, poorly understood complication after breast cancer axillary lymph node dissection.
    • AWS causes painful scar tissue (cording) limiting arm and shoulder mobility.
    • Current treatments are limited, necessitating investigation into novel therapeutic approaches.

    Purpose of the Study:

    • To better understand the pathophysiology and treatments for axillary web syndrome.
    • To evaluate the preliminary efficacy of two novel treatment methods: percutaneous needle cord disruption with fat grafting and Xiaflex injection.

    Main Methods:

    • A literature search identified studies on axillary cording post-breast cancer surgery.
    • Eighteen patients underwent percutaneous cord disruption with autologous fat grafting.
    • One patient received Xiaflex injection for axillary cording.

    Main Results:

    • Traditional treatments like physical therapy and NSAIDs show variable efficacy, with symptom resolution typically within 3 months.
    • The novel treatments significantly improved shoulder and arm range of motion.
    • Both percutaneous cord disruption with fat grafting and Xiaflex injection led to reduced pain and improved aesthetic outcomes, including softening of the cords.

    Conclusions:

    • Axillary web syndrome is an incompletely understood postoperative complication requiring further research.
    • Severe cases of AWS may not respond to conventional therapies, indicating a need for more aggressive interventions.
    • Percutaneous needle cord disruption with fat grafting and Xiaflex injection represent promising alternative treatment options for managing AWS.