Incidence and risk factors for axillary web syndrome after breast cancer surgery

• Published in: Breast cancer research and treatment Vol. 131; no. 3; pp. 987 - 992
• Main Authors: Bergmann, Anke, Mendes, Valéria Vasconcellos, de Almeida Dias, Ricardo, do Amaral e Silva, Blenda, da Costa Leite Ferreira, Maria Giseli, Fabro, Erica Alves Nogueira
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01-02-2012; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Arms; Axilla; Biological and medical sciences; Breast cancer; Breast Neoplasms - surgery; Cancer; Cancer research; Cancer therapies; Cohort Studies; complications; Epidemiology; Female; Gynecology. Andrology. Obstetrics; Humans; Incidence; Injuries; Lymph Node Excision - adverse effects; Lymphatic system; Mammary gland diseases; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Obesity; Oncology; pain; Postoperative Complications - epidemiology; Postoperative period; Prospective Studies; Risk Factors; Sentinel Lymph Node Biopsy - adverse effects; surgery; Tumors; Axillary web syndrome; Lymph node excision; Breast neoplasm; Incidence; Breast disease; Excision; Lymph node; Breast tumor; Breast cancer; Malignant tumor; Epidemiology; Mammary gland diseases; Treatment; Surgery; Risk factor; Internet; Cancer; Axillary
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-011-1805-7

The objective of the study is to estimate the incidence and risk factors of axillary web syndrome (AWS) in early postoperative period (45 days). From the prospective cohort of women undergoing breast cancer surgery, we collected the variables related to patient characteristics, treatment, tumor, and postoperative complications. We performed bivariate and logistic regression. A total of 193 patients are included with a mean age of 58.26 years, majority of which are women who are overweight or obese (72.3%). The incidence of AWS was 28.1%. The presence of pain in the ipsilateral upper-limb associated with AWS was reported in 5.4% of the patients, and the shoulder joint restriction was observed in 11.4%. When controlling for confounding between AWS and the factors that showed statistical significance in bivariate analysis, the variables that explain the occurrence of the AWS were the type of axillary surgery, where women who underwent sentinel lymph node biopsy showed 68% less risk compared with those that underwent axillary lymphadenectomy (AL) (RR = 0.32; 95% CI, 0.13−0.79;
P
value = 0.014) and numbness in the arm after an injury of the intercostobrachial nerve, which is 3.19 times the risk of the AWS (RR = 3.19; 95% CI, 1.40−7.29,
P
value = 0.006). From the above findings, we concluded that the incidence of AWS was 28.1%, and it was associated with AL and numbness in the arm after injury of the intercostobrachial nerve.