Effect Of Myofascial Release in Combination with Muscle Energy Techniques on Axillary Web Syndrome in Post Radical Mastectomy Breast Cancer Patients

Main Article Content

Pratik Pawar
Trupti S. Yadav
Rashmi A. Gudur
Malti Vijay Bhambure


In the early stages of breast cancer, surgery is often the first choice for treatment. It can also be used as an extra treatment in the later stages. A few of the many surgeries used to treat breast cancer are sentinel lymph node biopsy (SLNB), lumpectomy, and surgical intervention mastectomy (MRM). After a modified radical mastectomy to axillary dissection of the lymph nodes (ALND), a woman's shoulder range of motion is greatly reduced (ROM). There are various physiotherapy treatment modalities, therapeutic exercises, manual therapies which include massage; myofascial release techniques and manual lymphatic drainage which need to be performed over an average period for three weeks to six months. These techniques are found to be effective in releasing the taut fibrous cord,   improving the shoulder range of motion and tissue mobility.

Article Details

How to Cite
Pawar, P. ., Yadav, T. S. ., A. Gudur, R. ., & Vijay Bhambure, M. . (2023). Effect Of Myofascial Release in Combination with Muscle Energy Techniques on Axillary Web Syndrome in Post Radical Mastectomy Breast Cancer Patients. Journal of Coastal Life Medicine, 11(1), 1454–1460. Retrieved from https://www.jclmm.com/index.php/journal/article/view/541


Harbeck N, Penault-Llorca F, Cortes J, Gnant M, Houssami N, Poortmans P, Ruddy K, Tsang J, Cardoso F. Breast cancer. Nat Rev Dis Primers. 2019 Sep 23;5(1):66. doi: 10.1038/s41572-019-0111-2. PMID: 31548545

Silberman AW, McVay C, Cohen JS, Altura JF, Brackert S, Sarna GP, Palmer D, Ko A, Memsic L. Comparative morbidity of axillary lymph node dissection and the sentinel lymph node technique: implications for patients with breast cancer. Ann Surg. 2004 Jul;240(1):1-6. doi: 10.1097/01.sla.0000129358.80798.62. PMID: 15213610; PMCID: PMC1356366.

Koehler LA, Haddad TC, Hunter DW, Tuttle TM. Axillary web syndrome following breast cancer surgery: symptoms, complications, and management strategies. Breast Cancer (Dove Med Press). 2018 Dec 20;11:13-19. doi: 10.2147/BCTT.S146635. PMID: 30588087; PMCID: PMC6304256.

Leidenius M, Leppänen E, Krogerus L, von Smitten K. Motion restriction and axillary web syndrome after sentinel node biopsy and axillary clearance in breast cancer. Am J Surg. 2003;185(2):127–130.

Koehler LA, Blaes AH, Haddad TC, Hunter DW, Hirsch AT, Ludewig PM. Research report movement, function, pain, and postoperative edema in axillary web syndrome. Phys Ther. 2015;95(10):1345–1353.

Rangarajan B, Shet T, Wadasadawala T, Nair NS, Sairam RM, Hingmire SS, Bajpai J. Breast cancer: An overview of published Indian data. South Asian J Cancer. 2016 Jul-Sep;5(3):86-92. doi: 10.4103/2278-330X.187561. PMID: 27606288; PMCID: PMC4991144.

Lewis PA, Cunningham JE. Dynamic Angular Petrissage as Treatment for Axillary Web Syndrome Occurring after Surgery for Breast Cancer: a Case Report. Int J Ther Massage Bodywork. 2016 Jun 3;9(2):28-37. doi: 10.3822/ijtmb.v9i2.297. PMID: 27257446; PMCID: PMC4868506.

Datar, Nirmiti A., and Vaishali Jagtap. "Effect of myofascial release in axillary web syndrome in carcinoma of breast." Executive Editor 13, no. 2 (2019): 105.

Serra-Añó P, Inglés M, Bou-Catalá C, Iraola-Lliso A, Espí-López GV. Effectiveness of myofascial release after breast cancer surgery in women undergoing conservative surgery and radiotherapy: a randomized controlled trial. Support Care Cancer. 2019 Jul;27(7):2633-2641. doi: 10.1007/s00520-018-4544-z. Epub 2018 Nov 24. PMID: 30470892.

Wang, Yanan Jin Jingxin, and Huayun Liu Jiamei Zhen. "Application of MET Technique after Upper Limb Dysfunction after Breast Cancer Surgery." Journal of Advances in Medicine Science| Volume 4, no. 02 (2021).

Torres Lacomba, María, Orlando Mayoral del Moral, José Luís Coperias Zazo, María José Yuste Sánchez, Jean-Claude Ferrandez, and Álvaro Zapico Goñi. "Axillary web syndrome after axillary dissection in breast cancer: a prospective study." Breast cancer research and treatment 117, no. 3 (2009): 625-630.

Leidenius, Marjut, Esa Leppänen, Leena Krogerus, and Karl von Smitten. "Motion restriction and axillary web syndrome after sentinel node biopsy and axillary clearance in breast cancer." The American Journal of Surgery 185, no. 2 (2003): 127-130.

Koehler, Linda A., David W. Hunter, Anne H. Blaes, and Tufia C. Haddad. "Function, shoulder motion, pain, and lymphedema in breast cancer with and without axillary web syndrome: an 18-month follow-up." Physical therapy 98, no. 6 (2018): 518-527.

Waxenbaum, Joshua A., and Myro Lu. "Physiology, Muscle Energy." (2020).

15.Agostini, Francesco, Carmine Attanasi, Andrea Bernetti, Massimiliano Mangone, Marco Paoloni, Edoardo Del Monte, Massimo Mammucari et al. "Web Axillary Pain Syndrome—Literature Evidence and Novel Rehabilitative Suggestions: A Narrative Review." International Journal of Environmental Research and Public Health 18, no. 19 (2021): 10383.

Gopinath, P. "Effect of Muscle Energy Technique and Conservative Exercises on Pain, Range of Motion and Shoulder Function in Patients with Adhesive Capsulitis." PhD diss., KG College of Physiotherapy, Coimbatore, 2016.

Crane, Patricia, Jaclyn Ladden, and Danielle Monica. "Treatment of axillary web syndrome using instrument assisted soft tissue mobilization and thoracic manipulation for associated thoracic rotation dysfunction." Physiotherapy Theory and Practice 34, no. 1 (2018): 74-78.

Josenhans, Elisabeth. "Physiotherapeutic treatment for axillary cord formation following breast cancer surgery." Pt_Zeitschrift für Physiotherapeuten 59, no. 9 (2007): 868-878.

Moskovitz, Alexander H., Benjamin O. Anderson, Raymond S. Yeung, David R. Byrd, Thomas J. Lawton, and Roger E. Moe. "Axillary web syndrome after axillary dissection." The American journal of surgery 181, no. 5 (2001): 434-439.

Jeong, Sangah, Byung Joo Song, Jiyoung Rhu, Cheolki Kim, Sun Im, and Geun-Young Park. "A Risk Factor Analysis of Axillary Web Syndrome in Patients After Breast Cancer Surgery: A Single Center Study in Korea." Annals of Rehabilitation Medicine 45, no. 5 (2021): 401-409.

Torres-Lacomba, María, Virginia Prieto-Gómez, Beatriz Arranz-Martín, Jean Claude Ferrandez, María José Yuste-Sánchez, Beatriz Navarro-Brazález, and Helena Romay-Barrero. "Manual Lymph Drainage With Progressive Arm Exercises for Axillary Web Syndrome After Breast Cancer Surgery: A Randomized Controlled Trial." Physical Therapy 102, no. 3 (2022): pzab314.

Cho, Youngki, Junghwa Do, Sunyoung Jung, Ohyun Kwon, and Jae Yong Jeon. "Effects of a physical therapy program combined with manual lymphatic drainage on shoulder function, quality of life, lymphedema incidence, and pain in breast cancer patients with axillary web syndrome following axillary dissection." Supportive Care in Cancer 24, no. 5 (2016): 2047-2057.

Fourie, W. J., and K. A. Robb. "Physiotherapy management of axillary web syndrome following breast cancer treatment: discussing the use of soft tissue techniques." Physiotherapy 95, no. 4 (2009): 314-320.

Tay, Matthew Rong Jie, Chin Jung Wong, and Hui Zhen Aw. "Prevalence and associations of axillary web syndrome in Asian women after breast cancer surgery undergoing a community-based cancer rehabilitation program." BMC cancer 21, no. 1 (2021): 1-7.

Invernizzi, Marco, Jisun Kim, and Nicola Fusco. "quality of life in breast cancer patients and survivors." Frontiers in Oncology 10 (2020): 620574.

Harris, Susan R. "Axillary web syndrome in breast cancer: a prevalent but under-recognized postoperative complication." Breast Care 13, no. 2 (2018): 129-132.

Rezende, Laura F., Ricardo Laier Franco, Vanessa Fonseca Vilas Boas, Juliana Lenzi, and Regiane Luz Carvalho. "Chronic axillary web syndrome: 83 months post lumpectomy-A Case report." Journal of Novel Physiotherapy and Physical Rehabilitation 7, no. 1 (2020): 013-014.

Roman, Mirela Mariana, Romain Barbieux, Christine Eddy, Clarence Karler, Isabelle Veys, Assaf Zeltzer, Nele Adriaenssens, Olivier Leduc, and Pierre Bourgeois. "Lymphoscintigraphic Investigations for Axillary Web Syndromes." Lymphatic Research and Biology 20, no. 4 (2022): 417-424.