Factors associated with morbidity of a totally implantable venous access device in patients with breast cancer.

Abstract

Background/aim: To investigate the possible morbidities associated with the implantation of a totally implantable venous access device (TIVAD) in breast cancer (BC) patients.

Materials and methods: Clinical data and developed complications in 546 BC patients with TIVAD between 2017 and 2021 were analyzed retrospectively. Among these, 524 (96%) patients who underwent TIVAD implantation via the right subclavian vein (SCV) route were examined separately.

Results: The mean patient age was 56.1 ± 11.4 years, and the mean patient body mass index was 25.3 ± 6.5. The incidence of early complications was 2.3% (12 cases), and the late complication incident rate was 2.6% (14 cases). Among these complications, ten (1.9%) catheter-related infections developed more frequently than others. Early complications increased as the number of puncture attempts rose and decreased with ultrasound guidance in the implantation, but no other predictive factors increased. No correlation existed between the patients' age, body mass index, BC side, puncture method, puncture number, surgical approach, radiotherapy, and late complications. There was no evidence that postoperative effects specific to BC surgery, such as increased pain, decreased functional capacity, and lymphedema, were altered with TIVAD implantation. For catheter-related infections only, adjuvant radiotherapy was a risk factor for patients with various comorbidities.

Conclusion: This study concludes that the right SCV approach remains a morbidity-safe route for TIVAD implantation in BC patients, as in other malignancies. The study suggests that clinicians can use other implantation routes to avoid catheter-related infection in patients scheduled for neoadjuvant treatment, who also have morbidity, and who are likely to receive postoperative radiotherapy.