Sally's struggle.
Sally* is a young school teacher who teaches a year 2 class at the local public school. She has been teaching for about 10 years. Sally was recently diagnosed with breast cancer of her right breast and was consequently away from school for the first term. She had a small lump removed along with some lymph nodes from under her arm and then this was followed by a course of radiotherapy. Sally is slim, fit and other than her breast cancer diagnosis, is healthy. She enjoys playing water polo for her old university club.
Sally was understandably stunned by her diagnosis as she had no family history of breast cancer. Things went smoothly though until a few weeks after her surgery, just before she started her twelve week course of radiotherapy. She started to find it extremely difficult to move her right arm and when she did so it was painful and tight. There was also a strange pulling sensation under her skin in her armpit and near her elbow. She was very worried about what this might be and concerned how it would affect her ability to teach and write on the whiteboard and play water polo in the future. Sally shared her concerns with a close friend who is a physiotherapist and she recommended Sally seek help from a physiotherapist specialising in patients who have had breast cancer.
Thankfully Sally took her friend’s advice. The physiotherapist identified Sally’s symptoms as Axillary Web Syndrome, commonly known as cording. Research varies as to how often it occurs, ranging from 20% to 72% of those patients who have had lymph nodes removed from under their arm. This syndrome occurs most often 3-4 weeks after surgery and less often outside this window. The defining characteristic of this syndrome is a web of skin in the armpit covering cords of tissue that become taut and painful when the shoulder is moved. With no treatment the cords usually spontaneously resolve within 3-8 months but until then movement is painful and uncomfortable.
Sally attended twice weekly sessions for a few weeks with her physiotherapist and the treatment consisted of soft tissue mobilization and gentle skin traction. Sally was also given stretching and exercises to do at home which she did regularly. Her shoulder movement restriction lessened and her pain and pulling sensation reduced after the first appointment. Being an active person and needing to use her right arm in the classroom Sally had been concerned that she would never regain her normal movement but this was not the case. By the start of term 2 Sally was back with her class carrying a few more scars but looking forward to being back in the swing of all her activities with no problems.
If you recognise yourself in Sally’s story, please seek help. West Ryde Physiotherapy who has had a wide range of experience treating women who have had breast cancer. You can contact her for an appointment on 9809 3854.
* not her real name
