Scientific Programme
Year 2021
October 2021


Abstract Title
Axillary web syndrome in outpatient post-operative breast cancer patients



Tan Tock Seng Hospital1, Singapore Cancer Society Rehabilitation Centre2

Background & Hypothesis

Axillary web syndrome (AWS) is an under-recognized complication of breast cancer surgery. Initially thought to be self-limiting, emerging data have demonstrated that AWS may persist longer than 12 weeks post surgery. and may causing persistent morbidity. Therefore, our aim is to investigate the prevalence and associations of AWS in post-operative breast Asian cancer patients up to 3 years after surgery.


This is a cross sectional observational study at a national cancer rehabilitation center. 111 Asian women who had undergone breast surgery and referred to a national outpatient rehabilitation center were recruited between Aug 2017 to July 2019. Appropriate descriptive statistics were used, and regression modelling was utilized to determine risk factors for AWS.


The prevalence of AWS in this population was 28.9%. The majority of patients presented at 1 and 2 years post surgery (34.1% for both groups), though there were 42 patients (31.2%) who presented 3-5 years post surgery. In the multivariate regression model, significant factors for AWS were age <50 years (OR = 3.51; 95% CI = 1.12-11.0;  p = 0.031) and axillary lymph node dissection (ALND) (OR = 6.54; 95% CI = 1.36-31.3; p = 0.019). There was reduced shoulder flexion range of motion (p<0.001) in patients with AWS compared to patients without AWS.

Discussion & Conclusion

The prevalence of AWS after breast cancer surgery is high even after the acute postoperative period. Patients, especially those with ALND and of a younger age, should be appropriately screened, given that shoulder morbidity can often be easily addressed with rehabilitation.