Treatment for breast cancer can lead to long-term complications such as reduced shoulder and arm function, reduced ROM, pain, and lymphedema.
Axillary web syndrome (AWS) or cording is another complication that often develops within weeks following breast cancer surgery and may present as one or more visible or palpable tight cords of tissue in the axilla, sometimes extending into the upper extremity or chest wall.
Risk factors include the removal of more lymph nodes (extensive surgery) and a lower BMI.
The etiology and natural history of AWS is still poorly understood, but centres around iatrogenic damage to the lymphatic and/ or venous system, resulting in local stasis, hypercoagulation, and inflammation of the involved supercial vein or lymphatic vessel.
AWS was previously thought to be self-limiting after 3 months, but recent research showed a 60% prevalence at 12 weeks.