Cording, or the medical term Axillary (under arm) web syndrome sometimes develops as a side effect of axillary lymph node dissection or sentinel lymph node biopsy.

Most people diagnosed with breast cancer need to have one or more of these surgeries.

These procedures involve removing a few or a lot of the underarm, lymph nodes.  When lymph nodes are removed to see if the cancer has spread, this causes the lymphatic vessels that are connected to the lymph nodes to harden and become fibrotic thus causing the thick ropey structures. The risk of Axillary Web syndrome to occur tends to be higher with a dissection of the lymph nodes as opposed to a sentinel node biopsy, however it can occur with either.

In women that develop this condition, its often but not always visible as a formation of cords or rope like structures under the skin on the inside of the arm towards the elbow. There can be many, or one just cord that run down the arm. It can appear thick and hard. It can also extend to the hand and the chest wall.

Cording can develop days, weeks or sometimes months after your surgery and tends to be noticeable when you lift or stretch your arm over above your shoulder or over your head.

Pain and tightness tend to be the feelings if you develop this syndrome. Range of motion in the affected arm can be compromised too.

If this condition goes untreated it can result in chronic pain, frozen shoulder, and immobility.

Treatment for cording is best treated under the guidance of a medical professional and a physiotherapist trained in Axillary web syndrome.

They may use various techniques to help the problem. This can include stretching exercises, gentle massage, moist heat, laser and pain medications.

Swimming is often helpful as well. It can help restore movement and reduce pain.

Cording is not usually a chronic condition. If treated properly it will resolve with therapy after just a few sessions or within a couple of months. It does help to continue mobility and stretching exercises at home. This will help if you need radiation. Radiation tends to harden the skin so if you are exercising it will help to prevent any mobility issues down the road.