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

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Summary

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.

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Authors and Affiliations

  1. Radiology Department, Centre Antoine Lacassagne, Nice, France

    P. -Y. Marcy & C. Bailet

  2. Radiotherapy Department, Institut Jules Bordet, 121 Boulevard de Waterloo, Bruxelles, Belgique, 1000

    N. Magné & P. Castadot

  3. Medical Oncology Department, Centre Antoine Lacassagne, Nice, France

    J. -C. Macchiavello

  4. Surgical Department, Centre Antoine Lacassagne, Nice, France

    M. Namer

  5. Radiology Department, Centre Antoine Baclesse, Caen, France

    J. -C. Gallard

Authors
  1. P. -Y. Marcy
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  2. N. Magné
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Correspondence to N. Magné.

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Marcy, P.Y., Magné, N., Castadot, P. et al. Radiological and surgical placement of port devices: a 4-year institutional analysis of procedure performance, quality of life and cost in breast cancer patients. Breast Cancer Res Treat 92, 61–67 (2005). https://doi.org/10.1007/s10549-005-1711-y

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