We wished to evaluate the prevalence and clinical features of axillary web syndrome (AWS) after sentinel node biopsy (SNB) and axillary lymph node dissection (ALND) during the conservative treatment of early breast cancer.

From March to November 2003, a total of 110 consecutive patients with clinical T1-T2 breast cancer underwent breast conserving surgery, with ALND being performed in 98 patients or SNB being performed in 12 patients. The diagnostic criterion for AWS was the presence of palpable and visible cords of tissue in the axilla upon maximal shoulder abduction. The extent of AWS was evaluated by inspection and by palpation of the axilla and the arm.

Ten of 110 patients (9%) developed AWS. The AWS typically presented in the first several weeks after surgery and it resolved within 1 month of onset for all the patients. AWS was encountered for 3 patients (25%) among the patients who had SNB and for 7 patients (8%) among the ALND group, which is not statistically significant. Typically, the syndrome was self-limiting, and it resolved without any specific treatment.

AWS is a significant cause of morbidity in the early postoperative period for 9% of the patients after axillary surgery. A more limited axillary surgery might help reduce the incidence and severity of the AWS.