Axillary Web Syndrome (cording)

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Lojo
Lojo Member Posts: 303
edited December 2015 in Lymphedema


Hi All,

I wanted to start a general topic to collect/focus discussion of axillary web syndrome. There are a few posts scattered around, but nothing really devoted to AWS (at least recently).

There is a nice article posted about it in the information area, which has been written or at least substantially updated since I first has some AWS last spring.

So, please post your experience with AWS, as there's not a whole lot of information out there.

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Comments

  • Lojo
    Lojo Member Posts: 303
    edited March 2015


    I'm back on the boards because my AWS has popped back up about 16 months after MX and SNB. I'm about a year done with rads. It initially flared up a few months after surgery right when I started rads and had to hold my arm over my head in the rads planning session. I went to 3 or 4 PT sessions and it went away completely.

    No problems for a year.. gradually went back to arm weights/strengthening at the gym...no problem.

    Then February and snow...shoveled my 90 yr old neighbor's sidewalk and boom it's back. There were two palpable cords initially. I did the exercises from PT, did some massage on myself and one snapped! Audibly! Creepy, but it seems to be gone. The other is still there and is mostly irritating. I have an appt with the RO next week and I'll see what she says (which will probably be to send me back to PT)

  • Binney4
    Binney4 Member Posts: 8,609
    edited March 2015

    Lojo, hello,

    Have you checked out the AWS information at StepUp-SpeakOut? There are links there for therapists to access as well. It's here:

    http://www.stepup-speakout.org/Cording_and_Axillar...

    Unfortunately it can come back--bummer! Hope this resolves again quickly. And I'm really sorry it raised its ugly head while you were doing a kindness for your neighbor. Hang in there--spring is just around the corner!

    Be well,
    Binney

  • Jennie93
    Jennie93 Member Posts: 1,018
    edited March 2015

    I got cording about 3 weeks after surgery and it has never gone away. It has decreased, little by little, so there is maybe some hope that someday it will, but at this rate it will take about 20 years, lol.....

  • Lojo
    Lojo Member Posts: 303
    edited March 2015

    Thanks Binney. I had read that last year, but went back and re-read it, which was useful. I think I'll go back to PT and see how it goes. It's not nearly as painful as it was last yr when I had to lie with my arm over my head for rads! Jennie, does yours bother you

  • kcat2013
    kcat2013 Member Posts: 391
    edited March 2015

    I had cording develop after BMX but didn't get it addressed until nearly a year later because I didn't realize what it was and that a PT could help with it. I'm thankful I asked here about it or I never would have known! I had some cording that extended under one of my breasts, in addition to the underarm. I saw a lymphedema therapist and she took care of it in 4 sessions. Lojo sorry that yours came back, I was unaware that was a possibility--will tuck that information away in case I ever need it!

    Kendra

  • Jennie93
    Jennie93 Member Posts: 1,018
    edited March 2015

    Oh yes, Lojo, it hurts like....... you know. :-(

  • Ariom
    Ariom Member Posts: 6,197
    edited March 2015

    I had the cording from where my nipple would have been and it stretched down my abdomen and under my ribs like tree branches. My Surgeon called it Mondors and said it would resolve itself. I had one branch snap, as I was turning over in bed, very strange sensation! I massaged the others for some time. I think it was around 12 weeks before it resolved and then I had a small branch come back about a year later, but it resolved fairly quickly.the second time.

  • BC2015
    BC2015 Member Posts: 86
    edited March 2015
    • I have it - showed up fairly soon after surgery (lump and 4 nodes) taken from same area. I can't straighten my arm out, it extends from the surgical site thru arm pit and down inside of arm to wrist. I have had one PT and scheduled for 3 next week. Need it to resolved some in order to start rads. It is horribly painful.
  • upstater15
    upstater15 Member Posts: 17
    edited October 2015

    I'm wondering if anyone has had this experience--I am 5 weeks out from LX/SNB (they thought they took 2 nodes, but it was really 4--there was a clump of 3). I've started to notice what looks like an AWS "cord" developing from my affected armpit extending a few inches into my upper arm on the affected side. But it doesn't hurt at all, or feel tight. It's definitely there though. Is this the early stages of AWS? I don't even know which dr to ask...my surgeon is 2.5 hours away at a major cancer center and I'm not scheduled to see him for another 2+ months. My RO and MO are both local...I'm 3 days into radiation, so I guess I can ask my RO on Monday.

    Thanks for any insight...

  • ThePrincess
    ThePrincess Member Posts: 424
    edited October 2015

    ah! I think I have this - I have a visible cord running under my underarm that I can feel pulling to my elbow. to releive it, we should massage gently? That's what my therapist says though I feel like taking a baseball bat to it? How do we make it go away?

  • glennie19
    glennie19 Member Posts: 6,398
    edited October 2015

    upstart: Yes, I would ask your RO. And I would suggest getting a referral to a certified lymphedema therapist who should be able to help you. Not all PT's or OT's are familiar with cording or AWS, but an LE therapist should be.

  • Binney4
    Binney4 Member Posts: 8,609
    edited October 2015

    Hi, Princess,

    Sorry to hear you're dealing with this! Here's more information about it:

    http://www.stepup-speakout.org/Cording_and_Axillar...

    Please do keep us posted on how you're doing. Gentle hugs,
    Binney

  • jill47
    jill47 Member Posts: 351
    edited December 2015
  • jill47
    jill47 Member Posts: 351
    edited December 2015

    Hi All - I bumped this topic b/c during LE therapy yesterday (I'm going on 2 months straight now for stage 1 LE) my therapist found a cord in between drain scar and right breast. Most likely it runs under my implant but cannot see where it ends, it's buried. The cord reared it's ugly head as a result of MLD moving fluids and reduced swelling. I still have much tightness and pain in trunk, more cords may be discovered. Been reading that cording can lead to lymphedema. I think my body did all it could to prevent LE but w/ the combo of cording and bi lateral breast cellulitis this year, it had no chance. So more therapy. BTW I love my therapist, sounds sick but I'm glad she found the cord, so I know it's not just LE that is causing pain, tightness.

  • marianelizabeth
    marianelizabeth Member Posts: 1,735
    edited December 2015

    Yikes, jill47. I hope that yours does not lead to lymphedema. My PT found my cording when I had complained to my PS and MO. Later I read that the MO commented on the cording but did not bother telling. Anyway, my PT and I now think that I live with mine. It is actually twinned and also goes under the implant. As long as I see my PT and go to lots of yoga with stretching it is stable but when I go away for weeks it does get bigger. PT suggests I ask PS if he can have a look in the spring~~I am on a wait list for an implant change.

    BTW, what is comedo necrosis?

  • jill47
    jill47 Member Posts: 351
    edited December 2015

    Hi Maria, yikes back to you too for a long term relationship with your therapist I have a sneaky suspicion I will to. Was it your LE therapist who recommended a new implant? How will changing your implant improve cording other maybe the cord is removed during surgery? Different typeor smaller implant? My PS gave me the referral for LE therapy so he is my treating Dr. For this aweful condition which was dx ( truncal and arm) when I started therapy in October. If any reconstruction needs to be done I am very comfortable with my PS. Comedo necrosis Is the most aggressive form of DCIS. Thanks for responding to my post.

  • calidancer
    calidancer Member Posts: 88
    edited December 2015

    Glad to find this thread. I have cording under my arm and I think down to my IMF scar on the side and under the implant. At first after my MX the cording was bad into my arm but I managed to break some of it up. My PS thought the cording would be released during exchange and she took out a lot of scar tissue but the cording is at least as bad. Time for PT. I'm not back in the gym yet, next week hopefully so maybe that will help some with the tightness. But I think the cording is interfering with the implant dropping into place as well... And it's so uncomfortable.

  • katykids
    katykids Member Posts: 132
    edited December 2015

    So, I have tried to research this. And I hope there are no stupid questions. I had a PBMX. No nodes removed but I have the tightest stringiest muscles from my chest to my armpit. I would have called them cords and then I read this board and saw they have a word for it but it seems to be for women that had nodes removed. Thank you in advance!

  • jill47
    jill47 Member Posts: 351
    edited December 2015

    Katykids - no stupid questions here. How many months out are your from surgery? Not sure lymph node removal causes cording but a mastectomy in of itself it very damaging to muscles, tissue, vessels and that can result in scar tissue maybe lead to cording. You don't mention if you have reconstruction but that adds more trauma to your chest. I'm 3.5 years out and still struggling. I had PT 4 months out from bmx and that therapist didn't even know what cording was, needless to say that round of PT didn't work. Get a PT consultation referral from your PS - make sure they've worked on patients who had mx.

  • marianelizabeth
    marianelizabeth Member Posts: 1,735
    edited December 2015

    jill, I am also dx 2012, July. When I read the threads on BCO, they talk about most being post op and resolved soon after though they can return. My did not develop until a year ago last fall and so about 8 0r 9 months post exchange. I have never liked my Allergen 410 hard and cold implant so nothing to do to with PT suggesting it. He thought it was worthwhile asking the PS as it does appear to extend under the implant and muscle. Calidancer, my PT and I hoped that the work he was doing plus stretching would cause that release or pop but no. What PT does do though is break it down and keep it from increasing in size which did happen last winter when I was away 10 weeks.

    jill, so glad to hear that your LE therapist has been able to work on arm/truncal~~how far into the trunk and arm? Sounds like you really have had what I call "cancer takeaways" far beyond your dx and surgeries?

    Katydids, yes when was your surgery as it can take time as jill says to figure out what will disappear with the healing process and what will slowly resolve or become perhaps an issue.

    BTW, my PT keeps me going in many ways~~before BC, he kept me trekking which is what I kind of do for a hobby~~leads treks in the Himalaya and I had motorcycle injuries from decades ago that eventually gave me some grief just pre BC. I am thankful that not only is he awesome but he is young enough that he can keep me going for a long time! I am also lucky to have insurance that pays for much of it as Canadian insurance does not pay for physio unless you are poor or have extended insurance.

    Unrelated, yesterday I had an abdominal CT scan with contrast (nothing to do with BC) and that was less than thrilling as they can't use the right Mx side and difficult to get it in the used up veins on the left. Finally called the IV team and I got the scan.

  • katykids
    katykids Member Posts: 132
    edited December 2015

    jill, I am about 5 months out and I did TE. I am doing PT with someone who has MX experience but we are working on my ROM. I have had 6 sessions. I am about 45 degrees on both arms to the side and a little less than 90 degrees in the front. I used to lift weights, TRX, pilates, yoga before all of this. My PS has kind of washed herhands of me and said your breasts look great. "One for the books."

    Thank you for your input. I will ask the PT to put her finger on the weird cord thing. I got a massage today and she said it was pec minor. But didn't really have anything to do for it. Pull your scapulas down.

    I just looked it up and I am pretty hunched over. And pec minor would effect that. :/

  • sheeprus
    sheeprus Member Posts: 3
    edited December 2015

    Hello, I am new to this site and was interested in the posts about AWS. I am 4 weeks out on BMX. I have cording on the left from axilla to the wrist which is quite painful to touch and with some movement. The right side is much better with just some tension in the axilla. I had my first PT session a few days ago with some increased soreness in the left arm even though she was not agressive with mobilization. My question is, what if any specific treatment techniques worked best to help this resolve? And did you develop LE later? Thanks

  • sheeprus
    sheeprus Member Posts: 3
    edited December 2015

    Hello, you asked what comedo necrosis was.

    It is where cells die in the tumor, I believe, primarily in the center of the tumor, due to such rapid cell growth on the outer areas of the tumor. This deprives the inner cells of blood/nutrients and they die (necrosis). Comedo refers to it resembling a black head like some of us get on our skin. Kind of a simplified explanation, but hope it helps.

  • Jennie93
    Jennie93 Member Posts: 1,018
    edited December 2015

    Sheeprus, there are some PTs that believe they can "massage away" the cording, however, they are wrong. DO NOT let anyone do that to you! They did it to me and it caused lymphedema.



  • Unbreakable01
    Unbreakable01 Member Posts: 153
    edited December 2015

    Jennie93 from your experience, what would you recommend looking for in a PT that is trying to assist with cording?  I'm waiting on a referral, but have read that many PTs don't have experience with cording. I don't want to make it worse.


  • marianelizabeth
    marianelizabeth Member Posts: 1,735
    edited December 2015

    Do ask if they have experience. Some don't even know what it is. I was seeing my pre BC to keep me trekking and we just moved right on to BC physio after each surgery and we were surprised when it appeared last year way after the last surgery which was the T/E removal with implant in~~that was almost two years ago. It was a 1cm in diameter a year ago and when I went away for 10 weeks it went to 10cm, now is twinned but not bigger and I have full ROM. I have never had any sign of L/E and do wear my sleeve when on long flights. I consider myself very lucky in that respect. Yoga helps.

  • jill47
    jill47 Member Posts: 351
    edited December 2015

    Hi Maria: from your question "so glad to hear that your LE therapist has been able to work on arm/truncal~~how far into the trunk and arm? Sounds like you really have had what I call "cancer takeaways" far beyond your dx and surgeries?" Yea, that's me and there's more (Left frozen shoulder "adhesive capulitis"; despite 2 rounds of PT to correct, had manipulation under anesthesia with debridement surgery(Jan 2014) follow up with 6 weeks of successful PT to restore left shoulder ROM. My LE trunk is in both breasts (any wonder??) both have pau d' orange and LE right upper arm to underarm. The LE developed after bi-lateral breast cellulitis March 2015 and the LE only got worse through a hot summer.

  • Jennie93
    Jennie93 Member Posts: 1,018
    edited December 2015

    Unbreakable, I don't really have any suggestions about finding a PT because I had no choice, there was only one place here that my insurance covered. But here is the lesson I learned the hard way. Don't let them do anything to you that hurts. The first time I went, the lady was very nice and gentle. She gave me exercises to do at home every day, said to stretch until I can feel the pull, but not to the point of pain. I have been doing these ever since (about 2 years now) and that's what has restored my ROM almost completely, and reduced the pain a good deal. But, the 2nd time I went, I got a different PT and she had the attitude that the cords could be massaged away, or broken up, or something. The LE lady had warned me never let anyone massage that arm, ever again. But this PT gal said she knew all about LE and acted like she knew what she was doing, and I stupidly believed her. Hindsight is 20-20 of course. But I should have stopped her the minute it became painful.

    Anyway, long story short, the next morning I woke up with a big puffy swelling right in front of the armpit, and now I get to live with that for the rest of my life. Oh, joy.



  • marianelizabeth
    marianelizabeth Member Posts: 1,735
    edited December 2015

    jill, meant to say mm not cm! Big difference. My PT has not massaged my cording but has tried to break it up. It has never been truncal only from under my armpit and extending under the pectoral muscle and thus the implant too. Never have had any LE so I count myself lucky.

    Just came from six monthly MO appt. and she could see the cording but also my good ROM so did not seem to be any alarm bells. On another topic totally I have been booked for a bone scan just because I mentioned lower hip pain for past couple of months. I aways think these things are part of aging and my activity but I go ahead and to the scan to rule out bad things!

    Jennie I am so sorry. Breaking up the cords is not thing but she clearly moved lymph around and now as you say, you get to live with it. Back to LE specialist possible?

    jill and jennie you both have cancer take-aways that seem to be ongoing~~I can only hope that either they get better or cease or at least don't get worse.

    I am off to a silent mindfulness retreat put on my our cancer agency (free as someone anonymous paid for 20 of us) from Wed. PM to Friday lunch time. This was made available to any of us who went through an 8 week Mindfulness Based Stress Reduction Course at our cancer agency in the past. No talking, reading, writing so it should be interesting.

    Marian

  • marianelizabeth
    marianelizabeth Member Posts: 1,735
    edited December 2015

    Cording worse! In two weeks I have developed the biggest cord so far. It leads right from the armpit right under the pectoral major muscle. Hard to describe but if I lift my arm and put my arm behind my back (ROM still great) it can be seen and felt. Physio was blown away today as it WAS NOT there 2 weeks ago. The one that twinned a few months ago is the same but there is another small small one below that. So now 4 but the big one is crazy. My PT suggested I call my BS who discharged me two years ago after mx and I called and left a message. I am on a wait-list for a reconstruction revision (maybe change implant out) in the spring so will be asking PS if he can do anything. Mysterious if you read what the moderators say on these threads at this point in time. Never a hint of Lymphedema!

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