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SIR 2025

Venous Interventions

Scientific Session

Session: General IR 2

Chest Port Placement Ipsilateral to Breast Cancer: Any Elevated Risk of Lymphedema?

Tuesday, April 1, 2025
3:18 PM – 3:27 PM CT
Location: Music City Center, 207 CD
Purpose: It is common practice for patients with breast cancer (BC) to receive a chest port contralateral to their cancer to avoid development of lymphedema especially in the setting of axillary lymph node dissection. Previous studies including a small number of patients demonstrated no increased risk of lymphedema in patients who had a port placed ipsilateral to breast cancer {1, 2}. The purpose of this study was to compare the rate of lymphedema between ports placed ipsilateral to and contralateral to BC, and to determine if ipsilateral port placement was an independent risk factor of lymphedema. 

Materials and Methods: Among 4424 ports placed in 4265 patients between 2013 and 2023, 391 ports were placed in patients with BC without history of bilateral mastectomies. Among these 60 were placed ipsilateral to (ipsilateral group) and 331 placed contralateral to BC (contralateral group). P</span>atient characteristics (age, gender, BMI, diabetes, steroid/anticoagulant/ antiplatelet agent use, leukopenia /neutropenia/ thrombocytopenia/ hypoalbuminemia at the time of port placement) and port characteristics (right vs. left, lumen number, catheter tip location, and prior port removal) were recorded. The rate of lymphedema was compared between groups using Poisson regression. Univariate proportional subdistribution hazards regression (PSHREG) was used to determine if ipsilateral chest port placement in breast cancer is an independent risk factor for lymphedema. 

Results: The cumulative follow-up period was not significantly different between the groups (Ipsilateral: 27,608 catheter-days, median: 327 catheter-days, range: 20-1,661 catheter-days; Contralateral: 133,540 catheter-days, median: 307 catheter-days, range: 1-2,085 catheter-days P = 0.62). A total of 109/391 patients developed lymphedema (27.8%, 0.66 cases of lymphedema/1000 catheter days), the median time to lymphedema was 211.5 days (range: 1-2.247 days). No significant difference in the rate of lymphedema is noted between groups (Ipsilateral: 13/60 (22.7%), 0.47/1000 catheter-days vs. Contralateral: 96/331 (29.0%), 0.72/1000 catheter-days, P=0.45). Univariate PSHREG analysis also indicated that ipsilateral port placement was not an independent risk for lymphedema (Hazard ratio: 0.72, 95% confidence interval: 0.41-1.28, P= 0.26). 

Conclusion: Port placement ipsilateral to breast cancer does not seem to be an independent risk factor for lymphedema based on this single institution retrospective study.