Cording

Axillary Web Syndrome is also known as “cording”. It is very common after mastectomy or lumpectomy with axillary node dissection (lymph node removal). It is characterized by pain in the armpit or elbow with tautness that increases when trying to straighten the elbow or lift the arm overhead. The pain and tautness may extend into the wrist or thumb. There is often a visible tightness or a “cord” that looks like a guitar string just beneath the skin that runs from the armpit to the elbow.

Cording-CroppedAxillary web syndrome occurs when there is an interruption of the axillary lymphatics during axillary or sentinel node dissection. Axillary web syndrome seems to be unrelated to the number of lymph nodes removed or the stage of the cancer diagnosis. The syndrome usually does not begin immediately after surgery. Rather, there is a delay of a few weeks before the initial symptoms occur.

Research suggests that thombosed (clotted) lymph vessels are responsible for the cording. The vessels are inflamed and become thicker and shorter. Axillary Web Syndrome usually responds well to physical therapy treatment within six to eight visits and does not have long-term effects.