Utilization of Forearm Crutches to Avoid Lymphedema After Breast Cancer Lymph Node Surgery: A Case Report

Background: Despite many patients with breast cancer being advised to limit upper extremity (UE) use, there is growing evidence that UE use is not associated with lymphedema. Subsequently, clinicians may be unsure of how to advise patients with a history of breast cancer who need assistive devices to ambulate. Study Design/Case Description: A 51-year-old woman who had recently undergone treatment for breast cancer sustained a knee injury requiring the use of crutches. Forearm crutches were used instead of axillary crutches to minimize the potential for irritation to the axillary lymphatic vessels and thus reduce the risk for lymphedema. L-Dex measures were used to monitor for lymphedema. Outcomes: L-Dex scores did not exceed the change of more than +7.1 to indicate the presence of lymphedema. Furthermore, there were no clinical signs or symptoms of lymphedema while using crutches and in the 7 months following. Discussion: Prolonged rigorous UE use by ambulating non-weight-bearing with forearm crutches within 1 to 2 months of treatment for breast cancer did not result in UE lymphedema. This case report reinforces the growing body of evidence that avoiding aggressive UE activity may not be necessary in those at low risk of lymphedema and informs assistive device prescription for patients with breast cancer.