CC BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2017; 39(11): 632-639
DOI: 10.1055/s-0037-1604181
Systematic Review
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Management of Axillary Web Syndrome after Breast Cancer: Evidence-Based Practice

Tratamento da síndrome de rede axilar pós-câncer de mama: prática baseada em evidências
Clarissa Medeiros da Luz
1   Physiotherapy Postgraduate Program, Center of Health and Sport Sciences, Universidade do Estado de Santa Catarina (Udesc), Florianópolis, SC, Brazil
,
Julia Deitos
1   Physiotherapy Postgraduate Program, Center of Health and Sport Sciences, Universidade do Estado de Santa Catarina (Udesc), Florianópolis, SC, Brazil
,
Thais Cristina Siqueira
1   Physiotherapy Postgraduate Program, Center of Health and Sport Sciences, Universidade do Estado de Santa Catarina (Udesc), Florianópolis, SC, Brazil
,
Marina Palú
1   Physiotherapy Postgraduate Program, Center of Health and Sport Sciences, Universidade do Estado de Santa Catarina (Udesc), Florianópolis, SC, Brazil
,
Ailime Perito Feiber Heck
1   Physiotherapy Postgraduate Program, Center of Health and Sport Sciences, Universidade do Estado de Santa Catarina (Udesc), Florianópolis, SC, Brazil
› Institutsangaben
Weitere Informationen

Publikationsverlauf

25. Januar 2017

05. Mai 2017

Publikationsdatum:
12. Juli 2017 (online)

Abstract

Axillary web syndrome is characterized as a physical-functional complication that impacts the quality of life of women who have undergone treatment for breast cancer. The present study aims to verify the physiotherapy treatment available for axillary web syndrome after surgery for breast cancer in the context of evidence-based practice. The selection criteria included papers discussing treatment protocols used for axillary web syndrome after treatment for breast cancer. The search was performed in the MEDLINE, Scopus, PEDro and LILACS databases using the terms axillary web syndrome, lymphadenectomy and breast cancer, focusing on women with a previous diagnosis of breast cancer who underwent surgery with lymphadenectomy as part of their treatment. From the 262 studies found, 4 articles that used physiotherapy treatment were selected. The physiotherapy treatment was based on lymphatic drainage, tissue mobilization, stretching and strengthening. The four selected articles had the same outcome: improvement in arm pain and shoulder function and/or dissipation of the axillary cord. Although axillary web syndrome seems to be as frequent and detrimental as other morbidities after cancer treatment, there are few studies on this subject. The publications are even scarcer when considering studies with an interventional approach. Randomized controlled trials are necessary to support the rehabilitation resources for axillary web syndrome.

Resumo

A síndrome da rede axilar (ou cordão axilar) é uma complicação físico-funcional que interfere na qualidade de vida de mulheres que foram submetidas a tratamento para o câncer de mama. O objetivo do presente estudo foi verificar os tratamentos fisioterapêuticos disponíveis para a síndrome da rede axilar após o tratamento cirúrgico do câncer de mama no contexto da prática clínica baseada em evidências. Utilizou-se como critério de inclusão artigos que discutissem protocolos de tratamento para a síndrome da rede axilar após o tratamento para o câncer de mama. A pesquisa foi realizada nas bases de dados MEDLINE, Scopus, PEDro e LILACS, utilizando como palavras-chave síndrome da rede axilar linfadenectomia e câncer de mama, com foco em mulheres com diagnóstico de câncer de mama que realizaram cirurgia com linfadenectomia como parte do tratamento. Dos 262 estudos encontrados, foram selecionados 4 artigos que utilizaram fisioterapia, os quais incluíram drenagem linfática, mobilização tecidual, alongamento e fortalecimento. Os quatro artigos selecionados tiveram desfechos similares: melhora da dor no membro superior e na função do ombro e/ou desaparecimento do cordão axilar. Embora a síndrome da rede axilar seja tão frequente e prejudicial quanto as outras morbidades após tratamento para o câncer, existem poucos estudos sobre esse tema. As publicações são ainda mais escassas quando se considera uma abordagem intervencionista. Estudos randomizados controlados são necessários para embasar as técnicas de reabilitação na síndrome da rede axilar após tratamento para o câncer de mama.

 
  • References

  • 1 DeSantis C, Ma J, Bryan L, Jemal A. Breast cancer statistics, 2013. CA Cancer J Clin 2014; 64 (01) 52-62
  • 2 Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin 2015; 65 (02) 87-108
  • 3 Nogueira PVG, Guirro ECO, Guirro RRJ, Palauro VA. [Effects of proprioceptive neuromuscular facilitation on functional performance of mastectomized women]. Fisioter Bras 2005; 6 (01) 28-35 Portuguese
  • 4 Reedijk M, Boerner S, Ghazarian D, McCready D. A case of axillary web syndrome with subcutaneous nodules following axillary surgery. Breast 2006; 15 (03) 411-413
  • 5 Moskovitz AH, Anderson BO, Yeung RS, Byrd DR, Lawton TJ, Moe RE. Axillary web syndrome after axillary dissection. Am J Surg 2001; 181 (05) 434-439
  • 6 Koehler LA, Blaes AH, Haddad TC, Hunter DW, Hirsch AT, Ludewig PM. Movement, function, pain, and postoperative edema in axillary web syndrome. Phys Ther 2015; 95 (10) 1345-1353
  • 7 Bernas MJ. Axillary web syndrome, the lost cord, and lingering questions. Lymphology 2014; 47 (04) 153-155
  • 8 Leduc O, Fumière E, Banse S. , et al. Identification and description of the axillary web syndrome (AWS) by clinical signs, MRI and US imaging. Lymphology 2014; 47 (04) 164-176
  • 9 Koehler LA, Hunter DW, Haddad TC, Blaes AH, Hirsch AT, Ludewig PM. Characterizing axillary web syndrome: ultrasonographic efficacy. Lymphology 2014; 47 (04) 156-163
  • 10 Leidenius M, Leppänen E, Krogerus L, von Smitten K. Motion restriction and axillary web syndrome after sentinel node biopsy and axillary clearance in breast cancer. Am J Surg 2003; 185 (02) 127-130
  • 11 Torres Lacomba M, Yuste Sánchez MJ, Zapico Goñi A. , et al. Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial. BMJ 2010; 340: b5396
  • 12 Leduc O, Sichere M, Moreau A. , et al. Axillary web syndrome: nature and localization. Lymphology 2009; 42 (04) 176-181
  • 13 Fukushima KF, Carmo LA, Borinelli AC, Ferreira CW. Frequency and associated factors of axillary web syndrome in women who had undergone breast cancer surgery: a transversal and retrospective study. Springerplus 2015; 4: 112
  • 14 Fourie WJ, Robb KA. Physiotherapy management of axillary web syndrome following breast cancer treatment: discussing the use of soft tissue techniques. Physiotherapy 2009; 95 (04) 314-320
  • 15 Wei P, Zhu L, Chen K, Jia W, Hu Y, Su F. Axillary web syndrome following secondary breast-conserving surgery: a case report. World J Surg Oncol 2013; 11: 8
  • 16 Ferrandez J, Serin D. Rééducation et cancer du sein. Paris: Masson; 1996
  • 17 Aydogan F, Belli AK, Baghaki S, Karabulut K, Tahan G, Uras C. Axillary web syndrome after sentinel node biopsy. Breast Care (Basel) 2008; 3 (04) 277-278
  • 18 Torres Lacomba M, Mayoral Del Moral O, Coperias Zazo JL, Yuste Sánchez MJ, Ferrandez JC, Zapico Goñi A. Axillary web syndrome after axillary dissection in breast cancer: a prospective study. Breast Cancer Res Treat 2009; 117 (03) 625-630
  • 19 Higgins J, Green S. Cochrane handbook for systematic reviews of interventions [Internet]. Chichester: Wiley; 2011 [cited 2012 Mar 20]. Available from: https://dhosth.files.wordpress.com/2011/12/cochrane-handbook-for-systematic-reviews-of-interventions.pdf
  • 20 Liberati A, Altman DG, Tetzlaff J. , et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009; 339: b2700
  • 21 Scottish Intercollegiate Guidelines Network [Internet]. Search filters. 2014 [cited 2015 Feb 17]. Available from: http://www.sign.ac.uk/methodology/filters.html
  • 22 Malta M, Cardoso LO, Bastos FI, Magnanini MM, Silva CM. STROBE initiative: guidelines on reporting observational studies. Rev Saude Publica 2010; 44 (03) 559-565
  • 23 von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. ; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg 2014; 12 (12) 1495-1499
  • 24 Lauridsen MC, Christiansen P, Hessov I. The effect of physiotherapy on shoulder function in patients surgically treated for breast cancer: a randomized study. Acta Oncol 2005; 44 (05) 449-457
  • 25 Cho Y, Do J, Jung S, Kwon O, Jeon JY. Effects of a physical therapy program combined with manual lymphatic drainage on shoulder function, quality of life, lymphedema incidence, and pain in breast cancer patients with axillary web syndrome following axillary dissection. Support Care Cancer 2016; 24 (05) 2047-2057
  • 26 Fukushima KFP, Silva HJ, Ferreira CWS. Alterações vasculares resultantes da abordagem cirúrgica da axila: uma revisão da literatura. Rev Bras Mastologia. 2011; 21 (02) 91-98
  • 27 Bergmann A, Mendes VV, de Almeida Dias R, do Amaral E Silva B, da Costa Leite Ferreira MG, Fabro EA. Incidence and risk factors for axillary web syndrome after breast cancer surgery. Breast Cancer Res Treat 2012; 131 (03) 987-992
  • 28 Nevola Teixeira LF, Veronesi P, Lohsiriwat V. , et al. Axillary web syndrome self-assessment questionnaire: Initial development and validation. Breast 2014; 23 (06) 836-843
  • 29 Cheville AL, Tchou J. Barriers to rehabilitation following surgery for primary breast cancer. J Surg Oncol 2007; 95 (05) 409-418
  • 30 Pou Chaubron M, Almendáriz Juárez A, Peñalva Padial G, Casermeiro Cortés J. El síndrome axillary-web, frecuente, pero infradiagnosticado. Rehabilitación. 2012; 46 (02) 175-178
  • 31 International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology. Lymphology 2013; 46 (01) 1-11
  • 32 Craythorne E, Benton E, Macfarlane S. Axillary web syndrome or cording, a variant of mondor disease, following axillary surgery. Arch Dermatol 2009; 145 (10) 1199-1200