Augusto Motta University Center, Av. Paris, 72 - Bonsucesso, Rio de Janeiro, RJ, 21041-020, Brazil.
Breast Cancer Res Treat. 2012 Feb;131(3):987-92. doi: 10.1007/s10549-011-1805-7. Epub 2011 Oct 11.
The objective of the study is to estimate the incidence and risk factors of axillary web syndrome (AWS) in early postoperative period (45 days). From the prospective cohort of women undergoing breast cancer surgery, we collected the variables related to patient characteristics, treatment, tumor, and postoperative complications. We performed bivariate and logistic regression. A total of 193 patients are included with a mean age of 58.26 years, majority of which are women who are overweight or obese (72.3%). The incidence of AWS was 28.1%. The presence of pain in the ipsilateral upper-limb associated with AWS was reported in 5.4% of the patients, and the shoulder joint restriction was observed in 11.4%. When controlling for confounding between AWS and the factors that showed statistical significance in bivariate analysis, the variables that explain the occurrence of the AWS were the type of axillary surgery, where women who underwent sentinel lymph node biopsy showed 68% less risk compared with those that underwent axillary lymphadenectomy (AL) (RR = 0.32; 95% CI, 0.13-0.79; P value = 0.014) and numbness in the arm after an injury of the intercostobrachial nerve, which is 3.19 times the risk of the AWS (RR = 3.19; 95% CI, 1.40-7.29, P value = 0.006). From the above findings, we concluded that the incidence of AWS was 28.1%, and it was associated with AL and numbness in the arm after injury of the intercostobrachial nerve.
本研究旨在评估乳腺癌术后早期(45 天)腋窝-web 综合征(AWS)的发生率和危险因素。我们从接受乳腺癌手术的前瞻性队列中收集了与患者特征、治疗、肿瘤和术后并发症相关的变量。我们进行了双变量和逻辑回归分析。共纳入 193 例患者,平均年龄为 58.26 岁,其中大多数为超重或肥胖患者(72.3%)。AWS 的发生率为 28.1%。有 5.4%的患者报告同侧上肢伴有 AWS 的疼痛,11.4%的患者出现肩关节受限。在控制 AWS 与在双变量分析中具有统计学意义的因素之间的混杂后,解释 AWS 发生的变量是腋窝手术类型,与接受腋窝淋巴结清扫术的患者相比,接受前哨淋巴结活检的患者发生 AWS 的风险降低了 68%(RR=0.32;95%CI,0.13-0.79;P 值=0.014),以及肋间臂神经损伤后手臂麻木,发生 AWS 的风险是其 3.19 倍(RR=3.19;95%CI,1.40-7.29,P 值=0.006)。基于上述发现,我们得出结论,AWS 的发生率为 28.1%,与 AL 和肋间臂神经损伤后手臂麻木有关。