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| |  Axillary Location for Central Venous Port Offers Benefits for Breast Cancer Patients: Presented at ACS By Jill Stein CHICAGO -- October 14, 2009 -- Subcutaneous ports produce the same complication rates when used to deliver chemotherapy in breast cancer patients whether they are placed at the midaxillary line or chest wall, researchers stated here today at the American College of Surgeons (ACS) 95th Annual Clinical Congress. However, the axillary chest wall location does not produce the negative cosmetic outcomes of chest wall ports, they said. Ivanesa Pardo, MD, Indiana University School of Medicine, Indianapolis, Indiana, and colleagues compared morbidity in patients with surgically implanted central venous ports that were placed in the subcutaneous tissues of the midaxillary line at the anterior border of the latissimus muscle versus the anterior chest wall. The study included 183 patients with breast cancer in whom ports were placed for the delivery of chemotherapy. Port location was determined by patient and surgeon preference. About three-quarters of ports were placed in the axillary position. Overall, there were 13 complications (9%) in the axillary-port group and 6 complications (13%) in the chest wall group (P = .45). Patients with axillary ports weighed less (a mean of 75.8 kg vs 84.9 g for the 2 groups, respectively; P = .0046) and were more likely to have catheters placed in the internal jugular vein (82% vs 56%) Dr. Pardo pointed out that the technique used to place a central venous port in the axillary location is fairly similar to that used for the anterior chest wall location. “The variability is encountered when tunnelling the catheter to the stick site [either jugular or subclavial vein] since the distance is longer,” she said. She added that the study is unique in that there are no other studies in the literature that describe alternative techniques or locations for central venous port placement. Notably, since 2003, the entire breast surgery faculty at her institution has “incorporated the technique into their repertoire.” Finally, she said that this new port location provides patients with a better cosmetic result since the port and subsequent scar can be hidden by the patient’s brassiere. [Presentation title: Central Venous Port Placement: A Comparison of Axillary Versus Anterior Chest Wall Placement. Abstract SE158-T]
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