Initial peripherally inserted central catheter tip position accuracy by puncture arm and associated factors in female patients with breast cancer: A retrospective cohort study.

Abstract

ObjectiveTo examine the association between puncture arm and initial peripherally inserted central catheter tip positioning accuracy in female breast cancer patients and to explore related factors associated with malposition.MethodsThis retrospective cohort study included 402 female breast cancer patients undergoing chemotherapy requiring peripherally inserted central catheter placement. Patients were categorized into left-arm and right-arm groups. Demographic, clinical, and operator variables were analyzed. Pre-procedural anxiety status was evaluated using the Perioperative Anxiety Scale-7. Placement accuracy was assessed radiographically. Multivariate logistic regression identified independent predictors, and model performance was evaluated using receiver operating characteristic curve analysis.ResultsIn the matched cohort, initial tip accuracy was higher in the right-arm group (90.4%) than in the left-arm group (80.8%; P = 0.013). Left-arm selection, advanced age, compromised vascular condition, high pre-procedural anxiety, and limited operator experience were identified as independent factors associated with initial tip accuracy (P < 0.05). The multivariable descriptive model showed an apparent area under the curve of 0.825.ConclusionsIn this single-center retrospective cohort, right-arm puncture was associated with higher initial peripherally inserted central catheter tip positioning accuracy than left-arm puncture in female breast cancer patients. However, because breast cancer-specific factors influencing arm selection, including surgery laterality and axillary lymph node management, radiotherapy, and lymphedema-related factors, were not systematically collected, this association should not be interpreted as a causal effect of puncture side alone. These findings are hypothesis-generating and underscore the need for individualized peripherally inserted central catheter planning that considers clinical feasibility, venous condition, patient anxiety, treatment-related arm-selection factors, and operator experience.