{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T11:25:07Z","timestamp":1789817107377,"version":"4.0.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2018,1,18]],"date-time":"2018-01-18T00:00:00Z","timestamp":1516233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/academic.oup.com\/journals\/pages\/about_us\/legal\/notices"}],"funder":[{"name":"University of Minnesota Foundation's Doctoral Dissertation Fellowship","award":["4072-9201-11"],"award-info":[{"award-number":["4072-9201-11"]}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30 CA77598"],"award-info":[{"award-number":["P30 CA77598"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Masonic Cancer Center and University of Minnesota"},{"name":"Women's Health Scholar"},{"name":"Powell Center Fund for Women's Health Advancement endowment at the University of Minnesota"},{"name":"University Minnesota Women's Health Research Program"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Axillary web syndrome (AWS) can develop following breast cancer surgery and presents as a tight band of tissue in the axilla with shoulder abduction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The objectives were to determine the prevalence and natural history of AWS and the association between AWS and function, range of motion, pain, lymphedema, and body mass index (BMI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>This study was a longitudinal prospective cohort study utilizing a repeated measures design.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Axillary web syndrome, function, shoulder range of motion, pain, and lymphedema (using circumference, bioimpedance spectroscopy, tissue dielectric constant) were assessed in women at 2, 4, and 12 weeks and 18 months following breast cancer surgery. Prevalence of AWS and the association with the measured outcomes were analyzed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Thirty-six women agreed to participate in the study. The cumulative prevalence of AWS was 50% (18\/36) at 18 months following breast cancer surgery. AWS was identified as a risk factor for reduced function. Women with AWS had statistically reduced range of motion, lower BMI, and higher number of lymph nodes removed compared to the non-AWS group. Forty-one percent (13\/32) of women had AWS at 18 months. AWS reoccurred in 6 women following resolution, and a new case developed beyond the early postoperative period. The overall prevalence of physical impairments ranged from 66% to 97% within the first 18 months following surgery regardless of AWS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Limitations<\/jats:title>\n                  <jats:p>Limitations include a small sample size and potential treatment effect.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>AWS occurs in approximately 50% of women following breast cancer surgery. It can persist for 18 months and potentially longer, develop beyond the early postoperative time period, and reoccur after resolution. Clinicians need to be aware of the chronicity of AWS and its association with reduced range of motion and function.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ptj\/pzy010","type":"journal-article","created":{"date-parts":[[2018,1,18]],"date-time":"2018-01-18T00:17:31Z","timestamp":1516234651000},"page":"518-527","source":"Crossref","is-referenced-by-count":55,"title":["Function, Shoulder Motion, Pain, and Lymphedema in Breast Cancer With and Without Axillary Web Syndrome: An 18-Month Follow-Up"],"prefix":"10.1093","volume":"98","author":[{"given":"Linda A","family":"Koehler","sequence":"first","affiliation":[{"name":"Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota Medical School, Mayo Mail Code 388, 420 Delaware St. SE, Minneapolis, MN 55455; and Masonic Cancer Center, University of Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W","family":"Hunter","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne H","family":"Blaes","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota; and Masonic Cancer Center, University of Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tufia C","family":"Haddad","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,1,18]]},"reference":[{"key":"2023011806112241500_bib1","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s10549-014-2846-5","article-title":"Shoulder and arm morbidity in sentinel node-negative breast cancer patients: A systematic review","volume":"144","author":"Verbelen","year":"2014","journal-title":"Breast Cancer Res Treat"},{"key":"2023011806112241500_bib2","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/1477-7525-8-92","article-title":"Upper-body morbidity following breast cancer treatment is common, may persist longer-term and adversely influences quality of life","volume":"8","author":"Hayes","year":"2010","journal-title":"Health Qual Life Outcomes"},{"key":"2023011806112241500_bib3","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1097\/AJP.0b013e3181dee988","article-title":"Severity of acute pain after breast surgery is associated with the likelihood of subsequently developing persistent pain","volume":"26","author":"Hickey","year":"2010","journal-title":"Clin J Pain"},{"key":"2023011806112241500_bib4","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/S0002-9610(01)00602-X","article-title":"Axillary web syndrome after axillary dissection","volume":"181","author":"Moskovitz","year":"2001","journal-title":"Am J Surg"},{"key":"2023011806112241500_bib5","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/S0002-9610(02)01214-X","article-title":"Motion restriction and axillary web syndrome after sentinel node biopsy and axillary clearance in breast cancer","volume":"185","author":"Leidenius","year":"2003","journal-title":"Am J Surg"},{"key":"2023011806112241500_bib6","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.2522\/ptj.20140377","article-title":"Movement, function, pain, and postoperative edema in axillary web syndrome","volume":"95","author":"Koehler","year":"2015","journal-title":"Phys Ther"},{"key":"2023011806112241500_bib7","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1007\/s10549-011-1805-7","article-title":"Incidence and risk factors for axillary web syndrome after breast cancer surgery","volume":"131","author":"Bergmann","year":"2012","journal-title":"Breast Cancer Res Treat"},{"key":"2023011806112241500_bib8","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1007\/s10549-009-0371-8","article-title":"Axillary web syndrome after axillary dissection in breast cancer: A prospective study","volume":"117","author":"Torres Lacomba","year":"2009","journal-title":"Breast Cancer Res Treat"},{"key":"2023011806112241500_bib9","first-page":"156","article-title":"Characterizing axillary web syndrome: Ultrasonographic efficacy","volume":"47","author":"Koehler","year":"2014","journal-title":"Lymphology"},{"key":"2023011806112241500_bib10","first-page":"164","article-title":"Identification and description of the axillary web syndrome (AWS) by clinical signs, MRI and US imaging","volume":"47","author":"Leduc","year":"2014","journal-title":"Lymphology"},{"key":"2023011806112241500_bib11","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s10549-013-2616-9","article-title":"Cording following treatment for breast cancer","volume":"140","author":"O\u2019Toole","year":"2013","journal-title":"Breast Cancer Res Treat"},{"key":"2023011806112241500_bib12","volume-title":"Measurement of Joint Motion: A Guide to Goniometry","author":"Norkin","year":"2009","edition":"4th ed"},{"key":"2023011806112241500_bib13","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1023\/A:1026564723698","article-title":"Long-term morbidity following axillary dissection in breast cancer patients\u2014clinical assessment, significance for life quality and the impact of demographic, oncologic and therapeutic factors","volume":"64","author":"Kuehn","year":"2000","journal-title":"Breast Cancer Res Treat"},{"key":"2023011806112241500_bib14","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1111\/j.1440-0960.1992.tb00081.x","article-title":"Modern treatment of lymphoedema. 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