Lymphology Association of North America (LANA) Practice Exam

Which best characterizes axillary web syndrome?

1. Tight fibrotic strings in the axilla, breast, trunk, and/or arm of a patient recovering from breast surgery

2. Spider-vein like vessels in the axillary space

3. Dilated superficial capillaries in the axillary space

4. Tight cords reaching from one axilla to the other after breast radiation

The correct answer is: Tight fibrotic strings in the axilla, breast, trunk, and/or arm of a patient recovering from breast surgery

Axillary web syndrome is characterized by the presence of tight fibrotic strings, often referred to as "cords," in the axilla, which can extend into the breast, trunk, and/or arm of a patient recovering from breast surgery. This condition typically arises after surgical interventions such as mastectomy or lymph node dissection, especially in breast cancer patients. The fibrotic cords can be palpated and are linked to changes and disruptions in the lymphatic system that occur due to the surgical procedure. The key features of axillary web syndrome include the fact that these tight cords can cause discomfort, restrict movement, and may mimic the appearance of tendons. They are not the result of vascular changes like those seen in conditions involving veins or capillaries, which helps differentiate this syndrome from other vascular conditions such as spider veins or dilated capillaries. Understanding this characterization is crucial for proper assessment and management of patients who present with symptoms after breast surgery, allowing healthcare providers to recognize this syndrome and incorporate appropriate therapies, such as physical therapy or manual lymph drainage, into the care plan.