Tailored approach to the choice of long-term vascular access in breast cancer patients

Area of Science:

• Oncology
• Medical Devices
• Surgical Procedures

Background:

• Vascular access is crucial for delivering intravenous chemotherapy in breast cancer treatment.
• Different devices like PICCs, arm ports, and chest ports are available, each with potential complications.
• Optimizing vascular access choice can improve patient outcomes and treatment safety.

Purpose of the Study:

• To compare the complication rates and indwelling times of three vascular access methods in breast cancer patients undergoing chemotherapy.
• To evaluate the safety and efficacy of peripherally inserted central catheters (PICCs), arm ports, and chest ports.
• To inform clinical decision-making regarding the most suitable vascular access device based on patient and treatment factors.

Main Methods:

• Retrospective analysis of 300 breast cancer patients from 2016-2018.
• Patients received either PICCs, arm ports, or chest ports for chemotherapy.
• Complication rates and complication-free catheter indwelling times were recorded and compared.

Main Results:

• Chest ports had the longest mean complication-free indwelling time (1357.6 days), followed by arm ports (997.8 days) and PICCs (366.8 days) (p=0.004).
• Overall complication rate was 3.7% (11/300), with PICCs having the highest number of complications (8/100).
• No cases of catheter-related bloodstream infection or deep vein thrombosis were reported for any device.

Conclusions:

• Peripherally inserted central catheters (PICCs), arm ports, and chest ports are viable and safe vascular access options for breast cancer chemotherapy.
• Chest ports offer the longest duration of complication-free use, while PICCs showed a higher complication incidence.
• Selecting the appropriate catheter based on clinical context and patient preference ensures safe and effective chemotherapy delivery.