Assessing Efficacy of Axillary Web Syndrome Treatment

NCT ID: NCT03284008

Last Updated: 2019-07-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-07-16

Study Completion Date

2019-01-30

Brief Summary

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The aim of this study is verify the effectiveness of manual maneuver associated with stretching exercises in the treatment of Axillary Web Syndrome.

Detailed Description

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Axillary Web Syndrome (AWS) is one of the short / medium-term sequela of surgical treatment for breast cancer with axillary dissection (AD) or sentinel lymph node biopsy (SLNB), with incidence reported in literature between 28% and 72%. AWS could be described as a thrombophlebitis of veno-lymph vessels due to a trauma of the region subjected to surgery, with the same characteristics of "Mondor's disease" diagnosed in post-traumatic and surgical areas where is a large presence of veno-lymphatic capillaries.

The syndrome onset occur in approximately 2-4 weeks after the surgery and its complete regression happen in 3-6 months after the onset. The clinical signs frequently described are pain and tension during movement in the axillary region, elbow, forearm and wrist, following the arm lymphatic pathway. Moreover, patients report difficulties in moving the arm into activities that require a moderate range of motion and could feel and see in the affected arm cords similar to a tendon. Even if the impairment can cause disability for a limited period of time, rehabilitation is usually advice to prevent further complications such as frozen shoulder, articular impeachment syndrome and long-term chronic pain, complications that could worsen patient's quality of life with a significant increase in costs and time to recovery.

Nowadays there are no studies in the literature that demonstrate the effectiveness of physiotherapy in AWS, with just case reports describing different treatments techniques, without a scientifically defined experimented rehabilitation protocol.

This experimental, monocentric, randomized clinical trial wants verify the effectiveness of a manual maneuver associated with stretching exercises in the treatment of AWS.

Conditions

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Axillary Web Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Manual manoeuver + stretching

Patients will receive a manual manoeuver treatment and education to perform stretching exercises at home.

Group Type EXPERIMENTAL

Manual manoeuver + stretching

Intervention Type OTHER

Patients in experimental group will receive, after AWS diagnose, a manual manoeuver to snap the cord, follow by a demonstration and education of the exercise to be made at home.

stretching exercise

Patients will receive education to perform stretching exercises at home.

Group Type ACTIVE_COMPARATOR

stretching exercise

Intervention Type OTHER

Patients in control group will receive, after AWS diagnose, just a demonstration and education of the exercise to be made at home.

Interventions

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Manual manoeuver + stretching

Patients in experimental group will receive, after AWS diagnose, a manual manoeuver to snap the cord, follow by a demonstration and education of the exercise to be made at home.

Intervention Type OTHER

stretching exercise

Patients in control group will receive, after AWS diagnose, just a demonstration and education of the exercise to be made at home.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Female patients with age between 18 and 70 years old
* Axillary dissection with or without plastic reconstruction with prothesis
* Positive diagnose of axillary web syndrome.
* Patients without mental or psychological problems which could affect the proposed treatment execution.
* Signed informed consensus form.

Exclusion Criteria

* Chronic or acute upper limb pathology which could affect the proposed treatment execution.
* Patients with mental or psychological problems which could affect the proposed treatment execution.
* Plastic reconstruction with abdominal (DIEP or TRAM) and dorsal grafts or with expander.
* Previous head and neck, sentinel lymph node biopsy or axillary dissection surgery.
* Previous breast, axillary or head and neck radiotherapy.
* Halsted mastectomy.
* Previous lymphedema.
* Bilateral axillary dissection surgery
* Physiotherapy treatment execute outside hospital during the study.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Fondazione Umberto Veronesi

OTHER

Sponsor Role collaborator

European Institute of Oncology

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Fabio Sandrin

Role: PRINCIPAL_INVESTIGATOR

European Institute of Oncolgy

Locations

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Istituto Europeo di Oncologia

Milan, Lombardy, Italy

Site Status

Countries

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Italy

References

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Bergmann A, Mendes VV, de Almeida Dias R, do Amaral E Silva B, da Costa Leite Ferreira MG, Fabro EA. Incidence and risk factors for axillary web syndrome after breast cancer surgery. Breast Cancer Res Treat. 2012 Feb;131(3):987-92. doi: 10.1007/s10549-011-1805-7. Epub 2011 Oct 11.

Reference Type BACKGROUND
PMID: 21987036 (View on PubMed)

Cheville AL, Tchou J. Barriers to rehabilitation following surgery for primary breast cancer. J Surg Oncol. 2007 Apr 1;95(5):409-18. doi: 10.1002/jso.20782.

Reference Type BACKGROUND
PMID: 17457830 (View on PubMed)

Wariss BR, Costa RM, Pereira AC, Koifman RJ, Bergmann A. Axillary web syndrome is not a risk factor for lymphoedema after 10 years of follow-up. Support Care Cancer. 2017 Feb;25(2):465-470. doi: 10.1007/s00520-016-3424-7. Epub 2016 Oct 4.

Reference Type BACKGROUND
PMID: 27704260 (View on PubMed)

Torres Lacomba M, Mayoral Del Moral O, Coperias Zazo JL, Yuste Sanchez MJ, Ferrandez JC, Zapico Goni A. Axillary web syndrome after axillary dissection in breast cancer: a prospective study. Breast Cancer Res Treat. 2009 Oct;117(3):625-30. doi: 10.1007/s10549-009-0371-8. Epub 2009 Mar 21.

Reference Type BACKGROUND
PMID: 19306057 (View on PubMed)

Moskovitz AH, Anderson BO, Yeung RS, Byrd DR, Lawton TJ, Moe RE. Axillary web syndrome after axillary dissection. Am J Surg. 2001 May;181(5):434-9. doi: 10.1016/s0002-9610(01)00602-x.

Reference Type BACKGROUND
PMID: 11448437 (View on PubMed)

Other Identifiers

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IEO S721/412

Identifier Type: -

Identifier Source: org_study_id

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