Evaluating the Efficacy of Manual Lymphatic Drainage, Stretching, Conservative Exercises, and Home-Based Interventions on Quality of Life in a Patient with Axillary Web Syndrome: A Case Report

Abstract

Background

Breast cancer is the most prevalent cancer among women, especially post-menopausal women due to decreased estrogen levels. Axillary Web Syndrome (AWS) is a common postoperative complication in women undergoing breast cancer treatment, particularly following axillary surgery. Characterized by visible or palpable cord-like subcutaneous tissue, AWS often causes pain and restricted shoulder mobility.

Case presentation:

This case report describes a 62-year-old woman who developed AWS within 20 days post-surgery, presenting with pain and reduced shoulder range of motion (ROM). During physical examination, string-like cords were observed extending from the armpit to the inner arm.

Interventions

A comprehensive rehabilitation strategy was implemented, including MLD, stretching, conservative exercises, and home-based interventions. MLD sessions focused on reducing lymphatic congestion and promoting fluid drainage. Stretching and conservative exercises targeted the pectoralis major and minor, biceps brachi, latissimus dorsi, and rotator cuff muscles. Home-based interventions included self-massage and low-intensity exercises.

Outcome

The patient experienced immediate symptom relief post-MLD session, with pain reduction from 9/10 to 0/10, increased shoulder abduction from 110⁰ to 170⁰, and improved shoulder flexion from 120⁰ to 180⁰. Muscular strength improved, and the Breast cancer-specific Quality (EORTC QLQ BR-23) score increased from 50 to 90.

Conclusion

This case demonstrates the efficacy of combining MLD, stretching, conservative exercises, and home-based interventions in managing AWS. The approach led to significant pain reduction and improved arm functionality. Although the results are promising, further research with a larger sample size is necessary to validate these findings and explore the long-term effects. This holistic approach should be considered for clinical practice in managing AWS, emphasizing patient education and self-management for sustained benefits.

DOI: https://doi.org/10.52783/lhep.2024.566