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2014 ; 47
(4
): 156-63
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Characterizing axillary web syndrome: ultrasonographic efficacy
#MMPMID25915976
Koehler LA
; Hunter DW
; Haddad TC
; Blaes AH
; Hirsch AT
; Ludewig PM
Lymphology
2014[Dec]; 47
(4
): 156-63
PMID25915976
show ga
The aim of this study was to determine if ultrasound could successfully
characterize axillary web syndrome (AWS) and clarify the pathophysiologic basis
of AWS as a vascular or lymphatic abnormality, or an abnormal tissue structure.
This prospective study evaluated women who developed AWS following breast cancer
surgery. Using an 18 MHz ultrasound transducer, images were taken of the AWS cord
and compared to mirror images on the contralateral side. A blinded radiologist
assessed the ultrasound characteristics of and structural changes in the skin and
subcutaneous tissue and formulated an opinion as to the side in which AWS was
located. Seventeen subjects participated in the study. No structure or
abnormality consistent with AWS could be identified by ultrasound. There were no
statistical differences between the ipsilateral and contralateral side in skin
thickness; subcutaneous reflector thickness, number or disorganization; or
subcutaneous tissue echodensity (p>0.05). The radiologist correctly identified
the side with AWS in 12 of 17 subjects (=0.41). A distinct ultrasonographic
structure or abnormality could not be identified in subjects with AWS using 18
MHz ultrasound. The inability to identify a specific structure excludes the
possibility that AWS is associated with vein thrombosis or a fascial abnormality,
and supports the theory that AWS may be pathology that is not visible with 18 MHz
ultrasound, such as microlymphatic stasis or binding of fibrin or other proteins
in the interstitial space.
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