RESUMEN
Objective@#To investigate the prevalence and risk factors of axillary web syndrome (AWS) in Korean patients. @*Methods@#This retrospective study included a total of 189 women who underwent breast cancer surgery and received physical therapy between September 2019 and August 2020. We analyzed AWS and the correlation between the patients’ demographics, underlying disease, type of surgery and chemotherapy or radiation therapy, and lymphedema. @*Results@#The prevalence of AWS was found to be 30.6%. In the univariable analysis, age, chemotherapy, and hypertension were related to AWS. Finally, the multivariable logistic regression revealed that chemotherapy (odds ratio [OR]=2.84; 95% confidence interval [CI], 1.46–5.53) and HTN (OR=2.72; 95% CI, 1.18–6.30) were the strongest risk factors of AWS. @*Conclusion@#To the best of our knowledge, this was the first study that explored the risk factors of AWS in a Korean population after breast cancer surgery. As almost one-third of patients suffer from AWS after breast cancer surgery, it is essential to closely monitor the development of AWS in patients with hypertension or undergoing chemotherapy.
RESUMEN
Swallowing can be affected by a variety of systemic diseases. The etiology of dysphagia in the geriatric population is usually overlooked due mainly to a presumed diagnosis of presbyphagia or difficulty in revealing the direct cause. On the other hand, dysphagia can be a meaningful clinical sign of premalignant systemic disease. A 78-year-old man, without any prior medical or family history, was admitted with the chief complaint of dysphagia with recent aspiration pneumonia. Instrumental swallowing tests revealed a severe degree of dysphagia due to decreased laryngopharyngeal sensation and weakness of the pharyngeal constrictor muscles. Extensive workup, including electromyography and laboratory tests, revealed severe sensorimotor peripheral polyneuropathy related to monoclonal gammopathy. Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant precursor of multiple myeloma, which is characterized by the proliferation of monoclonal proteins. These conditions are often associated with peripheral polyneuropathy, ataxia, and sometimes even muscle weakness. Although dysphagia can occur in other systemic disorders, such as vasculitis or paraneoplastic syndrome-related malignancies, there are few reports of dysphagia related to MGUS. The patient was followed up for three years. The MGUS showed no further progression, but the patient showed no improvement, indicating a protracted clinical course and poor prognosis when dysphagia is related to MGUS.