Breast Cancer Research and Treatment

, Volume 92, Issue 1, pp 61–67 | Cite as

Radiological and surgical placement of port devices: a 4-year institutional analysis of procedure performance, quality of life and cost in breast cancer patients

  • P. -Y. Marcy
  • N. Magné
  • P. Castadot
  • C. Bailet
  • J. -C. Macchiavello
  • M. Namer
  • J. -C. Gallard


Purpose. The present study is designed to evaluate and compare percutaneous radiologic arm port (R) and surgical subclavian port (S) devices in two homogeneous sets of breast cancer patients in terms of safety, efficacy, quality of life (QoL) and cost analysis.

Material and methods. This study involved a retrospective review of a prospective databank including 200 consecutive port device implantation attempted procedures performed over a 4-year period, in two similar groups of 100 breast cancer women who underwent either the surgical cephalic vein cutdown approach or the percutaneous basilic vein catheterization for intravenous adjuvant chemotherapy. Parameters analyzed included technical success, procedure duration, complications, QoL and cost evaluation for both techniques.

Results. The success rate for port implantation was higher for R than for S placement (96% versus 91%). Mean implant duration time was 5.6 and 7.6 months for R and S, respectively. The overall complication rate was 10 and 16% for R and S, respectively. Mean implant duration time, without any complication or death, was 6.4 and 7.8 months for R and S, respectively. Six and seven percent for R and S, respectively, had to be removed prematurely. Both techniques exhibited very good QoL. Direct costs were respectively 230.8 and 219.1 € for R and S, respectively.

Conclusion. The significant advantages of R over S include higher success rate, higher cosmetic results despite a 15% relative overcost for R placement. Both are indicated for breast cancer chemotherapy treatment, nevertheless R placement is mandatory in anxious patients who fear surgery, in case of previous cervico-thoracic irradiation or upper extremity venous thrombosis, or in patients at risk of respiratory insufficiency.


breast cancer patient chemotherapy percutaneous radiologic arm port device quality of life surgical subclavian port device 


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  1. 1.
    Niederhuber, JE, Ensminger, W, Gyves, JW, Liepman, M, Doan, K, Cozzi, E 1982Totally implanted venous and arterial access system to replace external catheters on cancer treatmentSurgery92706712PubMedGoogle Scholar
  2. 2.
    Pullyblank, AM, Carey, PD, Pearce, SZ, Tanner, AG, Guillou, PJ, Monson, JR 1994Comparison between peripherally implanted ports and externally sited catheters for long-term venous accessAnn R Coll Surg Engl763338PubMedGoogle Scholar
  3. 3.
    Kock, HJ, Pietsch, M, Krause, U, Wilke, H, Eigler, FW 1998Implantable vascular access systems: experience in 1500 patients with totally implanted central venous port systemsWorld J Surg221216PubMedGoogle Scholar
  4. 4.
    Di Carlo, I, Cordio, S, La Greca, G, Privitera, G, Russello, D, Pulco, S, Latteri, F 2001Totally implantable venous access devices implanted surgically. A retrospective study on early and late complicationsArch Surg13610501053PubMedGoogle Scholar
  5. 5.
    Povoski, SP 2000Prospective analysis of the cephalic vein cutdown approach for chronic indwelling central venous access in 100 consecutive cancer patientsAnn Surg Oncol7496502CrossRefPubMedGoogle Scholar
  6. 6.
    Kamat, A, Kramer, P, Soisson, AP 2002Cephalic vein cutdown for inserting indwelling subclavian catheters in gynecologic oncology patientsWV Med J981517Google Scholar
  7. 7.
    Schwarz, RE, Groeger, JS, Coit, DG 1997Subcutaneous implanted central venous access devices in cancer patients: a prospective analysisCancer7916351640CrossRefPubMedGoogle Scholar
  8. 8.
    Shetty, PC, Mody, MK, Kastan, DJ, Sharma, RP, Burke, MW, Venugopal, C, Burke, TH 1997Outcome of 350 implanted chest ports placed by interventional radiologistsJ Vasc Interv Radiol8991995PubMedGoogle Scholar
  9. 9.
    Simpson, KR, Hovsepian, DM, Picus, D 1997Interventional radiologic placement of chest wall ports: results and complications in 161 consecutive placementsJ Vasc Interv Radiol8189195PubMedGoogle Scholar
  10. 10.
    Foley, MJ 1995Radiologic placement of long-term central venous peripheral access system ports (PAS Port): results in 150 patientsJ Vasc Interv Radiol6255262PubMedGoogle Scholar
  11. 11.
    Funaki, B 2002Central venous access: a primer for the diagnostic radiologistAJR179309318PubMedGoogle Scholar
  12. 12.
    Starkhammar, H, Bengtsson, M, Gain, TB, Galen, W, Hakansson, L, Hirsch, J, Loggie, B, Schuman, ES, Sterchi, JM 1990A new injection portal for brachially inserted venous catheter. A multicenter studyMed Oncol Tumor Pharmacother7281285PubMedGoogle Scholar
  13. 13.
    Kaufman, JA, Salamipour, HS, Geller, SC, Rivitz, SM, Waltman, AC 1996Long-term outcomes of radiologically placed arm portsRadiology201725730PubMedGoogle Scholar
  14. 14.
    Lyon, RD, Griggs, KA, Johnson, AM, Olsen, JR 1999Long-term follow-up of upper extremity implanted venous access devices in oncology patientsJ Vasc Interv Radiol10463471PubMedGoogle Scholar
  15. 15.
    Hills, JR, Cardella, JF, Cardella, K, Waybill, PN 1997Experience with 100 consecutive central venous access arm ports placed by interventional radiologistsJ Vasc Interv Radiol8983989PubMedGoogle Scholar
  16. 16.
    Bodner, LJ, Nosher, JL, Patel, KM, Siegel, RL, Biswal, R, Gribbin, CE, Tokarz, R 2000Peripheral venous access ports: outcomes analysis in 109 patientsCardiovasc Intervent Radiol23187193CrossRefPubMedGoogle Scholar
  17. 17.
    Cassidy, FP, Zajko, AB, Bron, KM, Reilly, JJ, Peitzman, AB, Steed, DL 1987Non infectious complications of long-term central venous catheters: radiologic evaluation and managementAJR149671675PubMedGoogle Scholar
  18. 18.
    Denny, DF 1993Placement and management of long-term central venous access catheters and portsAJR161385393PubMedGoogle Scholar
  19. 19.
    Kidney, DD, Nguyen, DT, Deutsch, LS 1998Radiologic evaluation and management of malfunctioning long-term central vein cathetersAJR17112511257PubMedGoogle Scholar
  20. 20.
    Andrews, JC, Marx, MV, Williams, DM, Sproat, I, Walker-Andrews, C 1992The upper arm approach for placement of peripherally inserted central catheters for protracted venous accessAJR158427429PubMedGoogle Scholar
  21. 21.
    Perry, EP, Nash, JR, Klidjian, AM 1990Direct cephalic vein cannulation for safe subclavian accessJ R Coll Surg Edinb35218220PubMedGoogle Scholar
  22. 22.
    Coates, A, Dillenbeck, CF, McNeil, DR, Kaye, SB, Sims, K, Fox, RM, Woods, RL,  et al. 1983Linear analogue self-assessment (LASA) in evaluation of aspects of the quality of life of cancer patients receiving therapyEur J Cancer Clin Oncol1916331637CrossRefPubMedGoogle Scholar
  23. 23.
    Allen, AW, Megargell, JL, Brown, DB, Lynch, FC, Singh, H, Singh, Y, Waybill, PN 2000Venous thrombosis associated with the placement of peripherally inserted central cathetersJ Vasc Interv Radiol1113091314PubMedGoogle Scholar
  24. 24.
    Burbridge, B, Krieger, E, Stoneham, G 2000Arm placement of the Cook titanium Petite Vital-Port: results of radiologic placement in 125 patients with cancerCan Assoc Radiol J51163169PubMedGoogle Scholar
  25. 25.
    Ballarini, C, Intra, M, Pisani Ceretti, A, Pagani, M, Farina, G, Perrone, S, Tomirotti, M, Scanni, A, Soina, GP 1999Complications of subcutaneous infusion port in the general oncology populationOncology5697102CrossRefPubMedGoogle Scholar
  26. 26.
    Gilsdorf, JR, Wilton, K, Beals, TF 1989Bacterial colonization of intravenous catheter materials in vitro and in vivoSurgery1063744PubMedGoogle Scholar
  27. 27.
    Brant-Zawadzki, M, Anthony, M, Mercer, EC 1993Implantation of a P.A.S. Port venous access device in the forearm under fluoroscopic guidanceAJR16011271128PubMedGoogle Scholar
  28. 28.
    Forauer, AR, Alonzo, M 2000Change in peripherally inserted central catheter tip position with abduction and adduction of the upper extremityJ Vasc Interv Radiol1113151318PubMedGoogle Scholar
  29. 29.
    Morris, SL, Jaques, PF, Mauro, MA 1992Radiology-assisted placement of implantable subcutaneous infusion ports for long-term venous accessRadiology184149151PubMedGoogle Scholar
  30. 30.
    Funaki, B, Szymski, GX, Hackworth, CA, Rosenblum, JD, Burke, R, Chang, T, Leef, JA 1997Radiologic placement of subcutaneous infusion chest ports for long-term venous accessAJR16915311534Google Scholar
  31. 31.
    Stegman, SJ 1976Guidelines for placement of elective incisionsCutis18723726PubMedGoogle Scholar
  32. 32.
    Lilienberg, A, Bengtsson, M, Starkhammar, H 1994Implantable devices for venous access: nurses’ and patients’ evaluation of three different port systemsJ Adv Nurs192128PubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • P. -Y. Marcy
    • 1
  • N. Magné
    • 2
  • P. Castadot
    • 2
  • C. Bailet
    • 1
  • J. -C. Macchiavello
    • 3
  • M. Namer
    • 4
  • J. -C. Gallard
    • 5
  1. 1.Radiology DepartmentCentre Antoine LacassagneNiceFrance
  2. 2.Radiotherapy DepartmentInstitut Jules BordetBruxellesBelgique
  3. 3.Medical Oncology DepartmentCentre Antoine LacassagneNiceFrance
  4. 4.Surgical DepartmentCentre Antoine LacassagneNiceFrance
  5. 5.Radiology DepartmentCentre Antoine BaclesseCaenFrance

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