Occurrence and Risk Factors with Axillary Network Syndrome after Breast Cancer Treatment: Systematic Review with Meta-analysis
DOI:
https://doi.org/10.32635/2176-9745.RBC.2023v69n3.3877Keywords:
breast neoplasms, lymphatic diseases, risk factors, axillaAbstract
Introduction: Breast cancer is the most common in women and surgery is the main treatment of choice. Axillary Web Syndrome (AWS) is a recurrent condition that occurs in up to 86% after surgery, presenting as a single cord or multiple cords in the subcutaneous tissues of the ipsilateral axilla, causing pain and limitation of movement. Objective: To investigate studies about the occurrence and factors associated with AWS post breast cancer treatment. Method: Systematic review with meta-analysis based in the PECOS methodology according to PRISMA guidelines at the databases PubMed, LILACS and EMBASE. Results: Five articles were selected with rate of occurrence of 35% of AWS. The associated factors found showed a minor relative risk (RR) of recurrence in those who underwent sentinel lymph node biopsy compared to those who were submitted to axillary dissection (RR 0.49; 95%CI [0.42;0.57] I²=95%, p=0.01). The appearance of AWS ranged from 35% to 39% in patients who submitted to chemotherapy and radiotherapy, but the type of surgery did not have a statistically significant result for triggering the syndrome. Conclusion: Individuals who underwent sentinel lymph node biopsy are less likely to develop the syndrome when compared to those who submitted to axillary dissection. Oncological therapies had similar percentages for the appearance of AWS and the type of surgery did not interfere in the evolution of the pathology.
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Koehler LA, Haddad TC, Hunter DW et al. Axillary web syndrome following breast cancer surgery: symptoms, complications, and management strategies. Breast Cancer (Dove Med Press); 2018;11:13-9. doi: https://doi.org/10.2147/BCTT.S146635 DOI: https://doi.org/10.2147/BCTT.S146635
Sun YS, Zhao Z, Yang ZN, et al. Risk factors and preventions of breast cancer. Int J Biol Sci. 2017;13(11):1387-97. doi: https://doi.org/10.7150/ijbs.21635 DOI: https://doi.org/10.7150/ijbs.21635
Silva JDD, Oliveira RR, Silva MT, et al. Breast cancer mortality in young women in Brazil. Front Oncol. 2021;10:569933. doi: https://doi.org/10.3389/fonc.2020.569933 DOI: https://doi.org/10.3389/fonc.2020.569933
Dinas K, Kalder M, Zepiridis L, et al. Axillary web syndrome: incidence, pathogenesis, and management. Curr Probl Cancer. 2019;43(6):100470. doi: https://doi.org/10.1016/j.currproblcancer.2019.02.002 DOI: https://doi.org/10.1016/j.currproblcancer.2019.02.002
Alkabban FM, Ferguson T. Breast cancer. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [updated 2022 Sept 26; cited 2022 Aug 21]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482286
Luz CM, Deitos J, Siqueira TC, et al. Management of axillary web syndrome after breast cancer: evidence-based practice. Rev Bras Ginecol Obstet. 2017;39(11):632-9. doi: https://doi.org/10.1055/s-0037-1604181 DOI: https://doi.org/10.1055/s-0037-1604181
Harris SR. Axillary web syndrome in breast cancer: a prevalent but under-recognized postoperative complication. Breast Care (Basel). 2018;13(2):132-5. doi: https://doi.org/10.1159/000485023 DOI: https://doi.org/10.1159/000485023
Shim YU, Chae YW, Park JW. Effectiveness of physical therapy management of axillary web syndrome following sentinel lymph node biopsy in breast cancer patients: case study. J Kor Phys Ther. 2016;28(2):142-8. doi: https://doi.org/10.18857/jkpt.2016.28.2.142 DOI: https://doi.org/10.18857/jkpt.2016.28.2.142
Cochrane Brasil [Internet]. São Paulo: The Cochrane Collaboration; c2022. Como fazer uma revisão sistemática Cochrane; [acesso 2021 ago 11]. Disponível em: https://brazil.cochrane.org/como-fazer-uma-revis%C3%A3o-sistem%C3%A1tica-cochrane
Moher D, Liberati A, Tetzlaff J, et al. Principais itens para relatar revisões sistemáticas e meta-análises: a recomendação PRISMA. Epidemiol Serv Saúde. 2015;24(2):335-42. doi: https://doi.org/10.5123/S1679-49742015000200017 DOI: https://doi.org/10.5123/S1679-49742015000200017
Ministério da Saúde (BR). Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Ciência e Tecnologia. Coordenação-Geral de Gestão do Conhecimento. Diretrizes metodológicas: elaboração de revisão sistemática e metanálise de estudos observacionais comparativos sobre fatores de risco e prognóstico [Internet]. Brasília (DF): Ministério da Saúde; 2014 [acesso 2022 ago 15]. Disponível em: https://bvsms.saude.gov.br/bvs/ct/PDF/diretrizes_metodologias_estudos_observacionais.pdf
Sterne JA, Hernán MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919. doi: https://doi.org/10.1136/bmj.i4919 DOI: https://doi.org/10.1136/bmj.i4919
Ministério da Saúde (BR). Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Ciência e Tecnologia. Diretrizes metodológicas: sistema GRADE: manual de graduação da qualidade da evidência e força de recomendação para tomada de decisão em saúde [Internet]. Brasília (DF): Ministério da Saúde; 2014 [acesso 2022 jul 10]. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_metodologicas_sistema_grade.pdf
Tay MRJ, Wong CJ, Aw HZ. Prevalence and associations of axillary web syndrome in Asian women after breast cancer surgery undergoing a community-based cancer rehabilitation program. BMC Cancer. 2021;21(1):1019. doi: https://doi.org/10.1186/s12885-021-08762-z DOI: https://doi.org/10.1186/s12885-021-08762-z
Sire A, Losco L, Cisari C, et al. Axillary web syndrome in women after breast cancer surgery referred to an Oncological Rehabilitation Unit: which are the main risk factors? A retrospective case-control study. Eur Rev Med Pharmacol Sci. 2020;24(15):8028-35. doi: https://doi.org/10.26355/eurrev_202008_22486
Ramírez-Parada K, Garay-Acevedo D, Mella-Abarca W, et al. Axillary web syndrome among Chilean women with breast cancer: incidence and possible predisposing factors. Support Care Cancer. 2020;28:2941-7. doi: https://doi.org/10.1007/s00520-019-05190-5 DOI: https://doi.org/10.1007/s00520-019-05190-5
Wariss BR, Costa RM, Pereira ACPR, et al. Axillary web syndrome is not a risk factor for lymphoedema after 10 years of follow-up. Support Care Cancer. 2016;25:465-70. doi: https://doi.org/10.1007/s00520-016-3424-7 DOI: https://doi.org/10.1007/s00520-016-3424-7
Moskovitz AH, Anderson BO, Yeung RS, et al. Axillary web syndrome after axillary dissection. Am J Surg. 2001;181(5):434-9. doi: https://doi.org/10.1016/s0002-9610(01)00602-x DOI: https://doi.org/10.1016/S0002-9610(01)00602-X
Koehler LA, Blaes AH, Haddad TC, et al. Movement, function, pain, and postoperative edema in axillary web syndrome. Phys Ther. 2015;95(10):1345-53. doi: https://doi.org/10.2522/ptj.20140377 DOI: https://doi.org/10.2522/ptj.20140377
O'Toole J, Miller CL, Specht MC, et al. Cording following treatment for breast cancer. Breast Cancer Res Treat. 2013;140(1):105-11. doi: https://doi.org/10.1007/s10549-013-2616-9 DOI: https://doi.org/10.1007/s10549-013-2616-9
Jeong S, Song BJ, Rhu J, et al. A risk factor analysis of axillary web syndrome in patients after breast cancer surgery: a single center study in Korea. Ann Rehabil Med. 2021;45(5):401-9. doi: https://doi.org/10.5535/arm.21092 DOI: https://doi.org/10.5535/arm.21092
Bergmann A, Mendes VV, Dias RA, et al. Incidence and risk factors for axillary web syndrome after breast cancer surgery. Breast Cancer Res Treat. 2012;131(3):987-92. doi: https://doi.org/10.1007/s10549-011-1805-7 DOI: https://doi.org/10.1007/s10549-011-1805-7
Hassan MSU, Ansari J, Spooner D, et al. Chemotherapy for breast cancer (Review). Oncol Rep. 2010;24(5):1121-31. doi: https://doi.org/10.3892/or_00000963 DOI: https://doi.org/10.3892/or_00000963
Chou YH, Liao SF, Chen DR, et al. Axillary web syndrome after surgery for breast cancer. Research Square [Preprint]. 2022. doi: https://doi.org/10.21203/rs.3.rs-1866360/v1 DOI: https://doi.org/10.21203/rs.3.rs-1866360/v1
Hennequin C, Belkacémi Y, Bourgier C, et al. Radiotherapy of breast cancer. Cancer Radiother. 2022;26(1-2):221-30. doi: https://doi.org/10.1016/j.canrad.2021.11.013 DOI: https://doi.org/10.1016/j.canrad.2021.11.013
Fukushima KFP, Carmo LA, Borinelli AC, et al. 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. doi: https://doi.org/10.1186/s40064-015-0889-7 DOI: https://doi.org/10.1186/s40064-015-0889-7
Pereira AP, Santos GR, Furtado LFT, et al. Mastectomia e mamoplastia na vida das mulheres com câncer de mama. Rev Cad Med. 2019;2(1):38-52.
Czajka ML, Pfeifer C. Breast cancer surgery. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [updated 2023 Feb 8; cited 2022 June 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553076
Tournieux TT. Fatores preditivos para um bom resultado estético em cirurgias conservadoras por câncer de mama. Rev Bras Cir Plást. 2012;27(1):37-48. doi: https://doi.org/10.1590/S1983-51752012000100008 DOI: https://doi.org/10.1590/S1983-51752012000100008
Hu J, Xia X, Yang H, et al. Dissection of level III axillary lymph nodes in breast cancer. Cancer Manag Res. 2021;13:2041-6. doi: https://doi.org/10.2147/CMAR.S290345 DOI: https://doi.org/10.2147/CMAR.S290345
Toomey A, Lewis CR. Axillary lymphadenectomy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [updated 2023 Feb 5; cited 2023 Feb 20]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557873
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