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Three Things to Know About Cording (Axillary Web Syndrome)

You’ve recently completed breast cancer surgery, so you’ve undoubtedly been through a lot. In the weeks following your surgery, you may have some pain. This is to be expected.

But if you begin to notice some pulling or sharp pain in your armpit you could have another unexpected surprise called axillary web syndrome, more commonly known as cording.

Although surprises are the last thing you need right now, if you treat cording early on, it can aid in your recovery and prevent chronic pain. Read on to learn more about cording, symptoms to watch out for and treatment options.

What is cording (axillary web syndrome)?

Axillary web syndrome, or cording, is a fairly common side effect of lymph node removal during breast cancer surgery.

“Some women may develop cording following a sentinel lymph node biopsy or axillary lymph node dissection,” said Brittany Murphy, MD, a breast surgical oncologist at Banner MD Anderson Cancer Center in Arizona. “We don’t know exactly why it happens, but it is thought to be caused by inflammation and scarring. While this may be true, cording is typically more superficial (meaning it’s just under the surface of the skin) than the major vessels and nerves in the underarm.”

Experts don’t know just how many women are impacted by cording, but it isn’t uncommon for it to go undiagnosed and untreated. Some women may confuse tightness and tension as normal side effects of their procedures, but in reality, they may be experiencing cording.

This condition usually starts within a few days but can also develop months after surgery for breast cancer.

How do I know if I have cording after breast cancer surgery?

If you have cording, you may first notice pain in your armpit. Maybe you notice this pain while washing your hair or reaching for something on a shelf above you. “It may feel like a cord running from your breast to your armpit,” Dr. Murphy said.

Over the next few weeks, you may begin to visibly see a rope or cord under your skin in the underarm. Zeynep Bostanci, MD, a breast surgical oncologist at Banner MD Anderson Cancer Center at Banner – University Medical Center Phoenix, described it as looking and feeling like a guitar string.

“The cording may extend down the inner arm, elbow or wrist,” Dr. Bostanci said. “These cords may create a pulling when the arm is raised and cause discomfort or pain. It can also be seen over the chest or abdomen, which is called truncal cording.”

What treatment options are available for cording?

Don’t worry! Many people who have cording can regain their normal shoulder and arm function with proper treatment.

Cording can be treated in a number of different ways, including stretching, massage and physical therapy. You can use these individually or in combination. The most important thing to remember is to just keep moving, Dr. Bostanci said.

“It’s important to keep moving the affected area, because immobility of the arm can worsen symptoms,” she said.

How to treat cording

Gentle stretching: It’s very important to stretch your arm every day to decrease pain and increase your arm’s mobility. Talk to your health care team or an occupational and physical therapist who can teach you the exercises and tell you how often you should do them at home.

Massage therapy: Massaging the area may help reduce pain and tightness. Your therapist can help soften the cords by gently pulling on the tissue under your arm to help release it.

Physical therapy: Physical therapy is highly effective at treating cording. Your physical therapist can work with you on improving your range of motion and give you flexibility and stretching exercises to do at home.

Occupational therapy: An occupational therapist can provide exercises that increase your fine motor skills. They can also help increase your independence with normal activities.

Other home remedies: If your doctor approves, you can manage the pain with over-the-counter pain relievers and apply moist heat to the area.

Takeaway

While the last surprise you want after breast cancer surgery is pain and stiffness due to cording, most cases can clear up with proper care and exercises. If you have recently had breast cancer surgery and are experiencing stiffness and pain, contact a Banner Health specialist for help. To find a Banner Health specialist near you, visit bannerhealth.com.

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