Ann Rehabil Med.  2021 Oct;45(5):401-409. 10.5535/arm.21092.

A Risk Factor Analysis of Axillary Web Syndrome in Patients After Breast Cancer Surgery: A Single Center Study in Korea

• Jeong S
• Song BJ
• Rhu J
• Kim C
• Im S
• Park GY

• KMID: 2521912
• DOI: http://doi.org/10.5535/arm.21092

Abstract

Objective
To investigate the prevalence and risk factors of axillary web syndrome (AWS) in Korean patients.
Methods
This retrospective study included a total of 189 women who underwent breast cancer surgery and received physical therapy between September 2019 and August 2020. We analyzed AWS and the correlation between the patients’ demographics, underlying disease, type of surgery and chemotherapy or radiation therapy, and lymphedema.
Results
The prevalence of AWS was found to be 30.6%. In the univariable analysis, age, chemotherapy, and hypertension were related to AWS. Finally, the multivariable logistic regression revealed that chemotherapy (odds ratio [OR]=2.84; 95% confidence interval [CI], 1.46–5.53) and HTN (OR=2.72; 95% CI, 1.18–6.30) were the strongest risk factors of AWS.
Conclusion
To the best of our knowledge, this was the first study that explored the risk factors of AWS in a Korean population after breast cancer surgery. As almost one-third of patients suffer from AWS after breast cancer surgery, it is essential to closely monitor the development of AWS in patients with hypertension or undergoing chemotherapy.

Keyword

Axillary web syndrome, Breast neoplasms, Risk factors, Prevalence, Surgery

Figure

• 

  Fig. 1. Flow chart of patients’ selection. A total of 215 patients were recruited, but 26 patients were lost for follow-up or had missing measurements. AWS, axillary web syndrome.

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  Fig. 2. Ultrasonography image of axillary web syndrome showing anechoic or hypoechoic cord with surrounding hyperechoic edges or structures in (A) longitudinal view (arrow) and (B) transverse view.

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  Fig. 3. Cochran-Armitage trend test of body mass index (BMI) and axillary web syndrome (AWS).

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