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Function, Shoulder Motion, Pain, and Lymphedema in Breast Cancer With and Without
Axillary Web Syndrome

KOEHLER LA; HUNTER DW; BLAES AH; HADDAD TC
PHYS THER , 2018, vol. 98, n° 6, p. 518-527
Doc n°: 187549
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1093/ptj/pzy010
Descripteurs : MB - CANCEROLOGIE, AD8 - DOULEUR, DD35 - PATHOLOGIE / EPAULE

Axillary web syndrome (AWS) can develop following breast cancer
surgery and presents as a tight band of tissue in the axilla with shoulder abduction. Objective: The objectives were to determine the prevalence and natural
history of AWS and the association between AWS and function, range of motion,
pain, lymphedema, and body mass index (BMI).
Design: This study was a
longitudinal prospective cohort study utilizing a repeated measures design.
Methods: Axillary web syndrome, function, shoulder range of motion, pain, and
lymphedema (using circumference, bioimpedance spectroscopy, tissue dielectric
constant) were assessed in women at 2, 4, and 12 weeks and 18 months following
breast cancer surgery. Prevalence of AWS and the association with the measured
outcomes were analyzed. Results: Thirty-six women agreed to participate in the
study. The cumulative prevalence of AWS was 50% (18/36) at 18 months following
breast cancer surgery. AWS was identified as a risk factor for reduced function.
Women with AWS had statistically reduced range of motion, lower BMI, and higher
number of lymph nodes removed compared to the non-AWS group. Forty-one percent
(13/32) of women had AWS at 18 months. AWS reoccurred in 6 women following
resolution, and a new case developed beyond the early postoperative period. The
overall prevalence of physical impairments ranged from 66% to 97% within the
first 18 months following surgery regardless of AWS. Limitations: Limitations
include a small sample size and potential treatment effect. Conclusion: AWS
occurs in approximately 50% of women following breast cancer surgery. It can
persist for 18 months and potentially longer, develop beyond the early
postoperative time period, and reoccur after resolution. Clinicians need to be
aware of the chronicity of AWS and its association with reduced range of motion
and function.

Langue : ANGLAIS

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