Characterizing axillary web syndrome: ultrasonographic efficacy.
Identifieur interne : 000F23 ( PubMed/Corpus ); précédent : 000F22; suivant : 000F24Characterizing axillary web syndrome: ultrasonographic efficacy.
Auteurs : L A Koehler ; D W Hunter ; T C Haddad ; A H Blaes ; A T Hirsch ; P M LudewigSource :
- Lymphology [ 0024-7766 ] ; 2014.
English descriptors
- KwdEn :
- Adult, Arm (diagnostic imaging), Axilla (diagnostic imaging), Axilla (surgery), Breast Neoplasms (surgery), Cohort Studies, Female, Humans, Lymph Node Excision (adverse effects), Lymphatic Vessels (diagnostic imaging), Lymphedema (diagnostic imaging), Lymphedema (etiology), Mastectomy, Mastectomy, Segmental, Middle Aged, Prospective Studies, Sensitivity and Specificity, Sentinel Lymph Node Biopsy (adverse effects), Skin (diagnostic imaging), Syndrome, Ultrasonography.
- MESH :
- adverse effects : Lymph Node Excision, Sentinel Lymph Node Biopsy.
- diagnostic imaging : Arm, Axilla, Lymphatic Vessels, Lymphedema, Skin.
- etiology : Lymphedema.
- surgery : Axilla, Breast Neoplasms.
- Adult, Cohort Studies, Female, Humans, Mastectomy, Mastectomy, Segmental, Middle Aged, Prospective Studies, Sensitivity and Specificity, Syndrome, Ultrasonography.
Abstract
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.
PubMed: 25915976
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pubmed:25915976Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Characterizing axillary web syndrome: ultrasonographic efficacy.</title><author><name sortKey="Koehler, L A" sort="Koehler, L A" uniqKey="Koehler L" first="L A" last="Koehler">L A Koehler</name></author><author><name sortKey="Hunter, D W" sort="Hunter, D W" uniqKey="Hunter D" first="D W" last="Hunter">D W Hunter</name></author><author><name sortKey="Haddad, T C" sort="Haddad, T C" uniqKey="Haddad T" first="T C" last="Haddad">T C Haddad</name></author><author><name sortKey="Blaes, A H" sort="Blaes, A H" uniqKey="Blaes A" first="A H" last="Blaes">A H Blaes</name></author><author><name sortKey="Hirsch, A T" sort="Hirsch, A T" uniqKey="Hirsch A" first="A T" last="Hirsch">A T Hirsch</name></author><author><name sortKey="Ludewig, P M" sort="Ludewig, P M" uniqKey="Ludewig P" first="P M" last="Ludewig">P M Ludewig</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2014">2014</date><idno type="RBID">pubmed:25915976</idno><idno type="pmid">25915976</idno><idno type="wicri:Area/PubMed/Corpus">000F23</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000F23</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Characterizing axillary web syndrome: ultrasonographic efficacy.</title><author><name sortKey="Koehler, L A" sort="Koehler, L A" uniqKey="Koehler L" first="L A" last="Koehler">L A Koehler</name></author><author><name sortKey="Hunter, D W" sort="Hunter, D W" uniqKey="Hunter D" first="D W" last="Hunter">D W Hunter</name></author><author><name sortKey="Haddad, T C" sort="Haddad, T C" uniqKey="Haddad T" first="T C" last="Haddad">T C Haddad</name></author><author><name sortKey="Blaes, A H" sort="Blaes, A H" uniqKey="Blaes A" first="A H" last="Blaes">A H Blaes</name></author><author><name sortKey="Hirsch, A T" sort="Hirsch, A T" uniqKey="Hirsch A" first="A T" last="Hirsch">A T Hirsch</name></author><author><name sortKey="Ludewig, P M" sort="Ludewig, P M" uniqKey="Ludewig P" first="P M" last="Ludewig">P M Ludewig</name></author></analytic><series><title level="j">Lymphology</title><idno type="ISSN">0024-7766</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Arm (diagnostic imaging)</term><term>Axilla (diagnostic imaging)</term><term>Axilla (surgery)</term><term>Breast Neoplasms (surgery)</term><term>Cohort Studies</term><term>Female</term><term>Humans</term><term>Lymph Node Excision (adverse effects)</term><term>Lymphatic Vessels (diagnostic imaging)</term><term>Lymphedema (diagnostic imaging)</term><term>Lymphedema (etiology)</term><term>Mastectomy</term><term>Mastectomy, Segmental</term><term>Middle Aged</term><term>Prospective Studies</term><term>Sensitivity and Specificity</term><term>Sentinel Lymph Node Biopsy (adverse effects)</term><term>Skin (diagnostic imaging)</term><term>Syndrome</term><term>Ultrasonography</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Lymph Node Excision</term><term>Sentinel Lymph Node Biopsy</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Arm</term><term>Axilla</term><term>Lymphatic Vessels</term><term>Lymphedema</term><term>Skin</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Axilla</term><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Cohort Studies</term><term>Female</term><term>Humans</term><term>Mastectomy</term><term>Mastectomy, Segmental</term><term>Middle Aged</term><term>Prospective Studies</term><term>Sensitivity and Specificity</term><term>Syndrome</term><term>Ultrasonography</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">25915976</PMID><DateCreated><Year>2015</Year><Month>04</Month><Day>28</Day></DateCreated><DateCompleted><Year>2015</Year><Month>05</Month><Day>26</Day></DateCompleted><DateRevised><Year>2016</Year><Month>11</Month><Day>25</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0024-7766</ISSN><JournalIssue CitedMedium="Print"><Volume>47</Volume><Issue>4</Issue><PubDate><Year>2014</Year><Month>Dec</Month></PubDate></JournalIssue><Title>Lymphology</Title><ISOAbbreviation>Lymphology</ISOAbbreviation></Journal><ArticleTitle>Characterizing axillary web syndrome: ultrasonographic efficacy.</ArticleTitle><Pagination><MedlinePgn>156-63</MedlinePgn></Pagination><Abstract><AbstractText>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.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Koehler</LastName><ForeName>L A</ForeName><Initials>LA</Initials></Author><Author ValidYN="Y"><LastName>Hunter</LastName><ForeName>D W</ForeName><Initials>DW</Initials></Author><Author ValidYN="Y"><LastName>Haddad</LastName><ForeName>T C</ForeName><Initials>TC</Initials></Author><Author ValidYN="Y"><LastName>Blaes</LastName><ForeName>A H</ForeName><Initials>AH</Initials></Author><Author ValidYN="Y"><LastName>Hirsch</LastName><ForeName>A T</ForeName><Initials>AT</Initials></Author><Author ValidYN="Y"><LastName>Ludewig</LastName><ForeName>P M</ForeName><Initials>PM</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>L30 CA142244</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Lymphology</MedlineTA><NlmUniqueID>0155112</NlmUniqueID><ISSNLinking>0024-7766</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Can Assoc Radiol J. 2001 Jun;52(3):193-5</RefSource><PMID Version="1">11436415</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Am J Surg. 2001 May;181(5):434-9</RefSource><PMID Version="1">11448437</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>AJR Am J Roentgenol. 2001 Oct;177(4):893-6</RefSource><PMID Version="1">11566698</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Clin Ultrasound. 2003 Feb;31(2):103-7</RefSource><PMID Version="1">12539252</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Am J Surg. 2003 Feb;185(2):127-30</RefSource><PMID Version="1">12559441</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Breast. 2006 Jun;15(3):411-3</RefSource><PMID Version="1">16257525</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Surg Radiol Anat. 2006 Dec;28(6):606-19</RefSource><PMID Version="1">17061033</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Breast J. 2009 Jul-Aug;15(4):381-4</RefSource><PMID Version="1">19601943</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lymphology. 2009 Dec;42(4):176-81</RefSource><PMID Version="1">20218085</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001132" MajorTopicYN="N">Arm</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001365" MajorTopicYN="N">Axilla</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001943" MajorTopicYN="N">Breast Neoplasms</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008197" MajorTopicYN="N">Lymph Node Excision</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D042601" MajorTopicYN="N">Lymphatic Vessels</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008408" MajorTopicYN="N">Mastectomy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015412" MajorTopicYN="N">Mastectomy, Segmental</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012680" MajorTopicYN="N">Sensitivity and Specificity</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D021701" MajorTopicYN="N">Sentinel Lymph Node Biopsy</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012867" MajorTopicYN="N">Skin</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013577" MajorTopicYN="N">Syndrome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014463" MajorTopicYN="N">Ultrasonography</DescriptorName></MeshHeading></MeshHeadingList><OtherID 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