Key points
- Cording is a side effect of breast cancer surgery.
- It is treated with physiotherapy or lymphoedema therapy.
Content:
Cording, or axillary web syndrome, occurs in about 10% of patients after surgery to the axilla. Removal of lymph nodes in the axilla causes the lymphatic vessels connected to these nodes to harden. The risk of cording increases with the number of nodes removed, however cording may also occur when only one lymph node is removed.
It can be felt as a tight, uncomfortable cord-like structure in the armpit that extends down the arm, sometimes as far as the wrist. It can also run down the trunk and into the chest wall. As cording thickens, it becomes palpable and visible as a tight ‘cord’ under the skin. This may present as a single cord or a web of hardened tissue in the axilla
The ‘cord’ can be painful and feel tight, and restricts patient’s movement. Onset is usually within days or weeks of breast cancer surgery.
Treatment requires referral to a lymphoedema therapist or physiotherapist. Treatment aims to release the tight tissue, restoring normal range of motion. This may involve stretching and flexibility exercises, lymphatic massage and pain relief. Some therapists may use low-level laser therapy.
There is no association between cording and lymphoedema, and cording does not raise the risk of developing lymphoedema.
