Axillary Web Syndrome (AWS) can occur following axillary surgery. It occurs most often in women undergoing lymph node removal for breast cancer. It is considered to be related to Mondor’s disease.


Synonyms: cording lymphedema, axillary adhesion syndrome


Clinical features:

(1) The patient has sentinel lymph node removal or lymph node dissection in an axilla.

(2) The patient develops restricted range of motion (abduction) in the upper extremity on the side of the axillary surgery.

(3) Pain and/or numbness may be present in the axilla and/or upper extremity. Numbness may be associated with injury to the intercostobrachial nerve.

(4) Palpation of the axilla shows one or more subcutaneous fibrous cords. These may be visible if the woman raises her arm above her head.

(5) The finding is transient and the cords usually disappear after a few weeks or months if nothing is done.


The cords are composed of occluded blood vessels which are surrounded by fibrosis. Pain may be related to nerve entrapment.


If the axillary web is treated aggressively then there is a risk of permanent lymphedema. Physical therapy and continued exercise may hasten recovery.


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