Axillary web syndrome is not a risk factor for lymphoedema after 10 years of follow-up

Bárbara Reis Wariss,ejane Medeiros Costa, Ana Carolina Padula Ribeiro Pereira, Rosalina Jorge Koifman, Anke Bergmann. Support Care Cancer (2017) 25:465–470

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Axillary web syndrome is not a risk factor for lymphoedema after 10 years of follow-up

Bárbara Reis Wariss,ejane Medeiros Costa, Ana Carolina Padula Ribeiro Pereira, Rosalina Jorge Koifman, Anke Bergmann. Support Care Cancer (2017) 25:465–470

OBJECTIVE:

The objective of this study was to evaluate the association between axillary web syndrome and the development of lymphoedema after 10 years of follow-up.

METHODOLOGY:

A prospective observational study in a hospital cohort of women diagnosed with breast cancer and treated at a referral centre for cancer. Patients were followed according to the routine of the hospital’s physical therapy service. In addition, a review of medical records was conducted for the period between 5 and 10 years of follow-up. Data on patient characteristics, treatment, tumour and postoperative complications were collected.

RESULTS:

In all, 964 patients were included, mostly <65 years old (75 %) and classified as being overweight (68 %). Disease was diagnosed as being up to stage IIA in 54.9 % of the cases; 65.1% underwent mastectomy and 83.8% had total axillary dissection. As adjuvant treatment, 61 % underwent chemotherapy, 63.5 % radiotherapy and 68 % hormone therapy. Among surgical complications, 62.6 % of patients had seroma, 40.7 % had necrosis, 35.9 % axillary web syndrome and 31.4 % lymphoedema. There was no association between axillary web syndrome and the development of lymphoedema (OR = 0.87, 95 % CI 0.65 to 1.15, p = 0.329).

CONCLUSION:

The occurrence of axillary web syndrome was not a risk factor for lymphoedema after 10 years of follow-up.

Main findings

  • This study concludes that axillary web syndrome is not as risk factor to developing lymphoedema.
  • “Lymphoedema was measured over the circumference of the upper limbs, with measurements made at 7and 14cm above and 7, 14 and 21cm below the elbow articular line. The segment volume was calculated by the following: V=h*(C2+Cc+c 2)/(p*12), where V is the volume of the segment member, C and c are the circumference between points and is the distance between the circumferences (C and c). The sum of the difference between each point corresponds to the estimated final volume. The volume of the limbs was compared and was considered as lymphoedema if there was a difference between the limbs of >200 ml.”
  • The reliability of this measurement procedure was not provided.