Five-Year Cumulative Incidence of Axillary Web Syndrome and Comparison in Upper Extremity Movement, Function, Pain, and Lymphedema in Survivors of Breast Cancer With and Without Axillary Web Syndrome.
Linda Koehler, Amanda Day, David Hunter and 3 others
PMID 35398047WHAT IT FOUND
Axillary web syndrome persisted in 50% of survivors five years after breast cancer surgery.
While function and pain did not differ between those with and without the condition, survivors with AWS had significantly reduced shoulder abduction range of motion both early and late post-surgery.
Key findings
01The cumulative incidence of axillary web syndrome reached 57% at five years, with 50% of participants showing signs of the condition at the final visit.
02Participants with axillary web syndrome had significantly lower shoulder abduction active range of motion compared to those without the condition at two and four weeks post-surgery.
03There was no significant difference in upper extremity function or pain scores between the group with axillary web syndrome and the group without it across the five-year period.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Small sample size (28 participants) reduced statistical power, particularly for secondary outcomes. Participants received varying amounts of rehabilitation treatment (46% received at least one session), which was not controlled for and may have influenced outcomes. The assessment for axillary web syndrome has been validated but reliability has not been tested. A single assessor who was not blinded to prior AWS status collected all data, introducing potential bias. No baseline pre-surgery measures of pain, function, or lymphedema were available for comparison.
Declared interests
None of the authors reported any conflicts of interest.
The easy way to misread this
Do not assume that normal function and pain scores indicate a lack of impairment. The study found no significant difference in DASH or pain scores between groups, yet those with AWS had significantly reduced shoulder abduction range of motion. Relying solely on self-reported function may miss persistent physical restrictions.