Cording after surgery for breast cancer

Cording is an uncomfortable feeling, like a tight cord running from the armpit to your hand. It can develop weeks or months after surgery for breast cancer.

What is cording?

Cording is a cord-like structure under the skin on the inner arm. It may develop if you have had surgery to remove lymph nodes in the armpit. This is also called axillary web syndrome (AWS).

You may be able to see or feel the cords when you lift your arm to shoulder height or above your head. There may be 1 thick cord or several smaller cords. They can cause a painful sensation and tightness. This can reduce the range of movement of your arm and shoulder. This can affect your ability to do many daily activities. There are lots of ways to help manage cording.

Cording may develop a few days after surgery, but it can develop a few weeks after. Sometimes it appears many months later. This is called a late effect.

Cording usually gets better slowly over a few months. But it can take longer. Sometimes it can come back, but this is rare. If the cording continues, you may be able to have surgery to improve symptoms.

Causes of cording

Doctors do not know exactly why cording happens. It is thought to be caused by inflammation and scarring of the tissues that surround the lymph vessels, blood vessels and nerves.

Cording is more common if you have had most of the lymph nodes removed from the underarm. This is called axillary lymph node dissection (ALND) or axillary node clearance (ANC). It is less likely to happen if you have had only 1 or 2 lymph nodes removed. This is called a sentinel lymph node biopsy (SLNB).

Managing cording

It is important to keep your arm and shoulder moving when you have cording. This helps prevent further tightness, which can cause more serious problems with movement.

The following tips may help:

  • Ask your cancer doctor or specialist nurse to refer you to a physiotherapist. They can teach you exercises to gently stretch the cords and improve movement. Your specialist nurse may also be able to help you.
  • Gentle massage to the area may help reduce pain and tightness. Your physiotherapist or specialist nurse may do this for you. They can also show you how to do it yourself.
  • Apply a warm, moist heat pad. The physiotherapist may do this for you. It is important not to use a heat pad for too long each time, as heat can increase the risk of lymphoedema.
  • If you have pain that stops you moving the arm and shoulder, ask your cancer doctor or GP for some painkillers. They may give you an anti-inflammatory painkiller, such as ibuprofen.

About our information

  • References

    Below is a sample of the sources used in our late effects of breast cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    Curigliano et al 2020. Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations. Annals of Oncology. Vol 31 (2). Available from: www.annalsofoncology.org/article/S0923-7534(19)36080-6/pdf [accessed November 2021].

    Fabi et al 2020. Cancer-related fatigue: ESMO Clinical Practice Guidelines for diagnosis and treatment. Annals of Oncology. Available from: www.annalsofoncology.org/article/S0923-7534(20)36077-4/pdf [accessed November 2021].

    National Institute for Health and Care Excellence (NICE). Early and locally advanced breast cancer: diagnosis and management. NG101. Available from: www.nice.org.uk/guidance/ng101 [accessed November 2021].

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Dr Rebecca Roylance, Consultant Medical Oncologist and Professor Mike Dixon, Professor of Surgery and Consultant Breast Surgeon.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

  • use plain English
  • explain medical words
  • use short sentences
  • use illustrations to explain text
  • structure the information clearly
  • make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.

Date reviewed

Reviewed: 01 July 2023
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Next review: 01 July 2026
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.