Tolerability, Safety and Efficacy of a Specific Rehabilitation Treatment Protocol for Axillary Web Syndrome: An Observational Retrospective Study

SIMPLE SUMMARY: Axillary web syndrome (AWS) is a common post-surgical sequela of breast cancer (BC) treatment. It determines pain and it limits the upper limb range of motion (ROM), reducing the quality of life of BC survivors. To date, various treatments and combinations of rehabilitative approaches have been proposed, but standardized guidelines are still lacking. The aim of our retrospective study was to assess the safety and tolerability of our specific AWS rehabilitative treatment protocol, and to determine its efficacy in reducing pain and improving upper limb ROM. We found that 60-min rehabilitative sessions composed of manual lymphatic drainage, stretching and mobility exercises, and soft tissue mobilization, performed three times/week until clinical resolution, represents a safe and well-tolerated rehabilitation protocol. Moreover, 98% of the patients reached complete shoulder ROM in flexion and abduction after the treatment, and there was a significant reduction in pain. ABSTRACT: Axillary web syndrome (AWS) is a highly prevalent surgical complication affecting BC survivors. It presents as a subcutaneous cording that limits the upper limb range of motion (ROM) and causes pain. Its etiology is still debated, and its treatment is not well defined. Therefore, we aimed to investigate the safety, tolerability and efficacy of our specific AWS rehabilitative treatment protocol. We conducted an observational retrospective study on a cohort of 92 AWS patients referred to the oncological outpatient service of a university hospital. We collected data from medical records before (T0) and after (T1) the treatment. The studied protocol was composed of 60-min sessions, carried out 3 times/week by specialized physiotherapists, until the clinical resolution of AWS. We found that a mean of 8.74 ± 2.12 rehabilitative sessions were needed, and only one patient stopped early. At T1, shoulder ROM was complete in both abduction and flexion in 98% of patients; AWS was no longer detectable in 64% of them, and pain significantly decreased compared to T0. In conclusion, our protocol proved to be safe, well-tolerated and seemed to be effective in treating AWS.