Cording after surgery for breast cancer

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.

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.