Fascial cording

[JanieMK]

I am a physical therapist who works with breast cancer patients. Often, after a LN dissection, the patient develops fascial cording. This is soft tissue tightness usually seen in the axilla. It can extend from the mastectomy or lumpectomy or even the drain scar down the arm to the wrist. It is painful and can recur.I have heard it referred to as tethered lymphatics or sclerosing lymphangitis but I rarely see anything written about what it actually is or why it occurs after LN dissection. The cords can be stretched and even broken and you see an immediate improvement in range of motion and a decrease in pain. Any thoughts?

[CCF-RN,MSN-JS]

Dear JanieMK, After discussing your question with collegues in surgery and physical therapy, the consensus is that problems with the tissue tightening or scarring are helped greatly with physical therapy.  The therapy treatment plan is individualized but usually involves soft tissue massage and stretching exercises.  

[surgeon]

early after axillary dissection, the lymphatic channels sometimes become congested, and can be seen under the skin. With time, with or without therapy, it usually improves. Scar tissue formation can also occasionally tether the skin, and this tends to soften with time as well. Range of motion exercises as well as such things as squeezing a ball may help during the time of scar tissue formation and softening. I've never heard it referred to as fascial cording; what fascia there is in the axillary region is very filamentous.

[japdip]

I had this problem a few weeks post-op. I had read something about this online and mentioned it to my surgeon .... he had no idea what I was talking about. He ordered a Venus Duplex because of a pinkish (not red) streak that ran down my arm from axilla to wrist. In approx. 6 weeks the condition went away after much stretching and exercising which was my own idea. I looked high and low in medical literature and couldn't find the word "cording" much less any information about this painful condition.

[A.L.]

Hello everyone here!
I am a physiotherapy student and I am doing my thesis on shoulder range of movement and the presence of cording after breast surgery, and I was wondering whether anyone has any links or has come across any articles containing information about this condition. If you happen to know where i could get information about this condition please email me at this email address audrey_losco***@****.
Thank you any information or help would be very appreciated.
Audrey

[LF]

I have a problem with cording, which has only gotten worse after taking Taxotere, because it affects the muscles and nerves.  Now that I'm done with chemo, I'm moving on to radiation.  I wonder if anyone could give me info about how radiation affects cording and if this condition will get better.  I've been in physical therapy for over 3 months now and do the exercises religiously to no avail.  Any help would be appreciated.

[cchelle]

I am 3 years post-op lumpectomy and axillary node dissection and I am having recent problems with "cording". I am an active swimmer and stretch regularly as part of that activity. Perhaps this is an area of post-cancer treatment that really needs more study. Especially since so many surgeons have never heard of such a thing. Cancer treatment is more that getting rid of the cancer; it is also about getting back to living.

[caringboyfriend2]

A related discussion, cording caused by interupted Lymph system? was started.

[pinchey]

A related discussion, cording was started.