Cording / Axillary Web Syndrome (AWS)

Posted by Laurie, Volunteer Mentor @roch, Apr 4, 2019


Does anyone have experience with Cording, also called Axillary Web Syndrome (AWS)

I recently found a rope like structures under the skin in my armpit. I asked my radiation oncologist about and he explained it was called Cording and is scar tissue. I had a lumpectomy and few lymph nodes removed 6 months ago and I did not notice any cording. I am on my 3rd week of radiation and cording is now apparent.

Here is an article on cording:
https://www.breastcancer.org/treatment/side_effects/aws

The dr did give me some stretching exercises.
I am interested in hearing from others who have had cording and if you had any treatment for.

Laurie M

Interested in more discussions like this? Go to the Breast Cancer Support Group.

i did get it following lumpectomy and lymph node removal. You really need to do the stretching exercises that they advised. If you are unsure how to do them, check with your physical therapist. By doing these, my cording subsided. If the physical therapist didn't give you any exercises to help prevent lymphedema, you should also check with them - there are simple exercises for that as well. Good luck to you.

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@trixie1313 , @roch Laurie, I did have cording and I agree with everything Trixie said. It does go away with exercise, and do be sure to follow instructions from your Oncologist about how to prevent lymphedema. I was alarmed, too, when I first noticed it, but it will subside with exercise.

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@sparklegram

@trixie1313 , @roch Laurie, I did have cording and I agree with everything Trixie said. It does go away with exercise, and do be sure to follow instructions from your Oncologist about how to prevent lymphedema. I was alarmed, too, when I first noticed it, but it will subside with exercise.

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@sparklegram @rolandsullivan
Our physical therapy department (Kaiser Permanente) has a 4-week program for strength training. You must be 8-10 weeks out of chemo to sign up. They instruct us in exercises and weights 1 day a week and we do the exercises 48 hours later. They have found that by doing this, it can reduce the chances of getting lymphedema by 70% and those with lymphedema have reduced times of bad bouts. Please check with your medical centers to see if these programs are available - it sounds like the more positive results, the more places will have these instructions.

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I have massive cording that started the day after my mastectomy and alnd. It's been there two years and no amount of physical therapy budges it, although I go in two hours a week for manipulation and working on the tight muscles it causes. I have about half the range of motion I had before. My PT thinks it is due to too much moving right after surgery, then inflammation caused by mild cellulitis that went on for weeks as I couldn't get the surgical team to diagnose it (the oncologist did, though), and then the surgical team had tried to do petrissage too early and without accompanying lymph drainage, resulting in even more cords forming. I have a couple of blood clotting mutations and had low normal BMI as well as being on blood thinners for six months after surgery, so those may also have added to the problem. At any rate, these cords are not dissolving or going away on their own or with traditional PT or massage. I've seen occasional references to releasing them surgically or via needling, so after this whole Covid thing is resolved, will look into that. Surgeons who deal with scarring from breast implants may be a resource.

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@dmpill

I have massive cording that started the day after my mastectomy and alnd. It's been there two years and no amount of physical therapy budges it, although I go in two hours a week for manipulation and working on the tight muscles it causes. I have about half the range of motion I had before. My PT thinks it is due to too much moving right after surgery, then inflammation caused by mild cellulitis that went on for weeks as I couldn't get the surgical team to diagnose it (the oncologist did, though), and then the surgical team had tried to do petrissage too early and without accompanying lymph drainage, resulting in even more cords forming. I have a couple of blood clotting mutations and had low normal BMI as well as being on blood thinners for six months after surgery, so those may also have added to the problem. At any rate, these cords are not dissolving or going away on their own or with traditional PT or massage. I've seen occasional references to releasing them surgically or via needling, so after this whole Covid thing is resolved, will look into that. Surgeons who deal with scarring from breast implants may be a resource.

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@dmpill
So sorry you are going through this. My cording went away last year after PT manipulation and home stretching exercise, however, it's B-A-C-K! Now instead of 1 cord, I have 2. Lucky me. Kind of feels like our arms are being ripped out of the skin, right? Due to the shelter-at-home, my PT was cancelled but I was able to get a video appointment. She's shown me an additional stretch which, while excruciating, I think it's helping a little. It's been explained to me that it like a blood vessel vein, but it's a lymph vein that's basically backed up with lymph "sludge." I've been looking on YouTube for an example - not sure if you're doing this one but about 2:20 it shows the PT stretching from the pectoralis muscle next to the breast tissue. This is now starting to help me somewhat. It's also important to do your lymphedema exercises 3X a day. I hope you get relief soon. This stuff is painful and annoying.

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Oh phooey -- I'm back in my swell spot ... after 4 years post-surgeries ... am having cording again. Thank goodness I kept my swell spots and post-surgery bras to fit these in. Well, I keep telling myself, it could be worse, at least I know what I need to do.

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@trixie1313

Oh phooey -- I'm back in my swell spot ... after 4 years post-surgeries ... am having cording again. Thank goodness I kept my swell spots and post-surgery bras to fit these in. Well, I keep telling myself, it could be worse, at least I know what I need to do.

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Dang @trixie1313, I'm sorry to hear about this set back. I wonder if @roch might have some tips to share.

Sure, there are worse things, but this is annoying. Trixie, what are the things you do that help?

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@colleenyoung

Dang @trixie1313, I'm sorry to hear about this set back. I wonder if @roch might have some tips to share.

Sure, there are worse things, but this is annoying. Trixie, what are the things you do that help?

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@colleenyoung
I'm back working on the pressure points and wearing my swell spot. It's already starting to soften up. If it doesn't go away, I'll ask for a referral to my PT specialist.

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@trixie1313

@colleenyoung
I'm back working on the pressure points and wearing my swell spot. It's already starting to soften up. If it doesn't go away, I'll ask for a referral to my PT specialist.

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@trixie1313 what does it mean swell spot?

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@polianad22
Swell spots are designed to break up fibrosis and also move fluid through the lymphatic system. I tend to get "cording" which is also known as axial webbing which can be a side effect of sentinel lymph node biopsy or axillary lymph node dissection. For me, it can be painful to lift my arm up due to the clogged lymph vein. The swell spots help break it up. I'm adding a site so you can see what they look like. My swell spot was covered under my insurance after it was okayed by my physical therapist contacting my doctor.
https://duckduckgo.com/?q=swell+spot+for+breast&iax=images&ia=images

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