Physiotherapy & Breast Cancer Surgery
Have you had Breast Cancer Surgery? Are you having surgery for Breast Cancer? Do you know someone that has had or is having breast cancer surgery?
Breast Cancer surgery can have side effects including:
Axillary Web Syndrome / Cording
Lymphoedema
Shoulder joint stiffness and muscle weakness
Physiotherapy evidence shows that early range of motion and strength exercises help improve shoulder movement and function after breast cancer surgery. Common side effects from Breast Cancer surgery can be improved and/or resolved with the help of a physiotherapist.
Axillary Web Syndrome
What is Axillary Web Syndrome (AWS)?
Also known as Cording, refers to the rope- or cord-like areas that develop just under the skin in the area under your arm. AWS can occur as a side effect after sentinel lymph node biopsy or axillary lymph node dissection, where some or many of the lymph nodes in the armpit are removed. Most breast cancer patients need to have at least one of these surgeries.
AWS/Cording can occur anywhere from several days to several weeks after surgery, and sometimes has been known to appear many months after surgery. It is a treatable complication.
Cause:
Research is limited into the cause of AWS but some experts believe that breast cancer surgery causes trauma to the connective tissue around the lymph vessels, blood vessels and nerves. This trauma causes inflammation, scarring and then hardening of the connective tissue which is when cording occurs.
What does it look and feel like?
AWS/Cording usually starts near the site of any scarring in the underarm or chest region, and extends down the inner arm towards the elbow and even into the palm of the hand.
Cording will look and/or feel like a web of thick, ropelike structures under the skin of the armpit/ inner arm. You may be able to see or feel several, smaller distinct cords or one large cord.
The cords will feel painful and tight with arm movement such as to shoulder level, overhead and possibly with straightening the elbow. This restriction of movement can impact daily activities and can be problematic if it occurs before or during radiation therapy where the arm is typically required to be held overhead.
What to do if you have Axillary Web Syndrome:
See a physiotherapist or lymphoedema therapist as soon as possible to eliminate pain, improve movement and resolve the condition.
How does Physiotherapy help?
Gentle soft tissue massage to help release the cords, decrease pain and increase arm range of motion.
Supervised stretching and flexibility exercises to stretch and release tension in the chest, armpit and down the arm.
Home exercise program and self-management plan.
Moist heat for tissue relaxation and pain relief. This must be used with caution as prolonged moist heat can increase production of lymph which can lead to fluid overload known as lymphoedema. The research is unclear as to whether AWS increases the risk of developing lymphoedema in the arm.
Cording typically resolves itself after a few therapy sessions or at least within a few months.