Axillary Web Syndrome (AWS) is an early post-operative complication after axillary lymph node dissection or sentinel lymph biopsy and can occur in non-breast cancer patients with axillary node biopsy. AWS is characterized by sudden upper arm pain, aggravated by elevating the shoulder, exhibiting tightness and limited range of motion. 

Subcutaneous tissue draws in, presenting cording under in the armpit, breast, chest wall and upper or lower arm. Post-operative exercises combined with Manual Lymphatic Drainage reduces the incidence of AWS.

In one 2017 study published in Journal of Phlebology and Lymphology, 400 women with breast cancer were randomly selected into two groups of 200 and compared for the incidence of AWS between physical exercises (PE) versus manual lymphatic drainage (MLD & PE). Women were instructed on the importance of self-care 24 hours before mastectomy surgery. After procedure, patients began PE or MLD & PE for three days with 20- to 30-minute sessions, twice daily. Patients continued self-care for three months, at which time the study period concluded.

The number of patients with AWS in the MLD & PE group were significantly fewer. At month one, PE: 20 vs. MLD & PE: 7. At month two, PE: 29 vs. MLD & PE: 5. At month three, PE: 22 vs. MLD & PE: 3.

Considering earlier studies regarding the prevention of lymphedema, MLD in combination with PE can be an effective strategy for preventing AWS and is a treatment needed for postoperative breast cancer survivors. 

Susan Couture, BSHA, CRC, LMT, LE, Cert. MLD/CDP works at OM Oracle Massage Lymphatic Therapy. Connect at 520-668-8731, [email protected] or OracleMassage.com. See ad, page 14.