October 31st marks Halloween, but it also marks the final day of Breast Cancer Awareness Month (BCAM), where every year during the month of October, women are encouraged to remember to be ‘breast aware’. So whilst we are being aware to check, let’s also be aware of the common complaints women experience after breast cancer surgery:-
- loss of shoulder range of movement
- tingling into the arm (especially where lymph nodes have been removed as well as breast tissue)
- reduced muscle power in the shoulder
- neck stiffness and loss of range of movement
- axilliary web syndrome (cording)
Axilliary Web Syndrome or cording can develop after the removal of lymph nodes which are located in the armpit. If cording develops, you will feel a tight/pulling sensation through the inner portion of your arm when raising your arm. Very often you can see one or more ropelike structures arising from the armpit, which travel towards the inside portion of the elbow and sometimes they can extend all the way to the palm of the hand. The cording can become apparent days, weeks or months after surgery.
We don’t fully know why cording occurs and what the cords are made up of. But current beliefs are that the trauma to the lymph nodes causes inflammation and scarring and eventual hardening of the local tissue, which can spread through the fibers of connective tissue.
Because the cords limit shoulder range of motion, the shoulder can get stiff and painful and therefore tasks of daily living can become difficult. If the cords extend below the elbow, the elbow and wrist can also suffer.
Treatment can include stretching, massage and manipulation of the scar tissue and cords. Your physiotherapist might also pull the arm and cords with the arm outstretched. This can cause the cords to snap and this snap will produce a pop sound. The arm can instantly free up, allowing pain free movement of the shoulder and elbow.
If you or someone you know thinks that they may have symptoms of cording, ask a doctor to refer onto a physiotherapist who specialises in breast cancer rehabilitation. If you leave it untreated, it may cause further complications with your shoulder/elbow and wrist.