C. A. Isom1, P. Bream3, R. N. Ahmed2, K. C. Gallagher2, S. Walia2, R. Kauffmann4 1Vanderbilt University Medical Center,General Surgery,Nashville, TN, USA 2Vanderbilt University,School Of Medicine,Nashville, TN, USA 3Vanderbilt University Medical Center,Radiology,Nashville, TN, USA 4Vanderbilt University Medical Center,Surgical Oncology & Endocrine Surgery,Nashville, TN, USA
Introduction:
The placement of subcutaneous central venous ports in breast cancer patients has become a common practice. Historically, ports have been placed on the side contralateral to the breast cancer due to concern about increased risk of complications with ipsilateral port placement. There have been only a few small studies evaluating complication rates between ports placed ipsilateral vs. contralateral to the breast cancer. We sought to determine if there was a difference in port complications or lymphedema rates by port location.
Methods:
A single institution retrospective review was conducted of adult (>18yrs) female patients undergoing central venous port placement for breast cancer treatment between 2012 and 2016. Patients that had ports placed by both surgery and interventional radiology were included. Patients were excluded if they had ports placed at another facility, their initial breast pathology was unavailable or treatment history was unavailable prior to their port placement.
Results:
A total of 581 females were identified with a mean age of 52.9 ±11.7 years. Ipsilateral ports were placed in 41 patients (7.1%). Ipsilateral ports were more likely to be placed via the internal jugular vein (56.1%) while contralateral ports were more likely to be placed in the subclavian vein (67.2%), p=0.002. There was no difference between type of breast surgery (p=0.997), axillary surgery (p=0.087) or administration of adjuvant radiation therapy (p=0.684) for patients that had ipsilateral vs contralateral ports. There was no difference in breast cancer stage at diagnosis but it did tend towards significance (p=0.0587). Ipsilateral ports were more likely to be on the right side, 73.2% vs 51.1% (p=0.006). Contralateral port were more likely to be placed for neoadjuvant therapy while ipsilateral ports were more likely to be placed for adjuvant therapy. Port complications requiring intervention occurred in 3(7.3%) patients with ipsilateral ports and 33(6.1%) patients with contralateral ports (p=0.73). Upper extremity lymphedema occurred in 8(20%) patients with ipsilateral ports and in 118(21.9%) of patients with contralateral ports (p=0.639).
Conclusion:
There was no difference in port complication or lymphedema rates between patients who had ports placed on the ipsilateral side compared to contralateral side for breast cancer treatment.