Scientific Publications Database

Article Title: Perceptions of vascular access for intravenous systemic therapy and risk factors for lymphedema in early-stage breast cancer-a patient survey
Authors: LeVasseur, N.; Stober, C.; Ibrahim, M.; Gertler, S.; Hilton, J.; Robinson, A.; McDiarmid, S.; Fergusson, D.; Mazzarello, S.; Hutton, T. B.; Joy, A. A.; McInnes, M.; Clemons, M.
Journal: CURRENT ONCOLOGY Volume 25 Issue 4
Date of Publication:2018
Abstract:
Background The choice of vascular access for systemic therapy administration in breast cancer remains an area of clinical equipoise, and patient preference is not consistently acknowledged. Using a patient survey, we evaluated the patient experience with vascular access during treatment for early-stage breast cancer and explored perceived risk factors for lymphedema.Methods Patients who had received systemic therapy for early-stage breast cancer were surveyed at 2 Canadian cancer centres.Results Responses were received from 187 patients (94%). The route of vascular access was peripheral intravenous line (IV) in 24%, a peripherally inserted central catheter (PICC) in 42%, and a surgically inserted central catheter (port) in 34%. Anthracycline-based regimens were associated with a greater use of central vascular access devices (CVADS- that is, a PICC or port; 86/97, 89%). Trastuzumab use was associated with greater use of ports (49/64, 77%). Although few patients (7%) reported being involved in the decisions about vascular access, most were satisfied or very satisfied (88%) with their access type. Patient preference centred mainly on avoiding delays in the initiation of chemotherapy. Self-reported rates of complications (183evaluable responses) were infiltration with peripheral IVs (9/44,20%), local skin infections with PICCS (7/77, 9%), and thrombosis with ports (4/62, 6%). Perceived risk factors for lymphedema included use of the surgical arm for blood draws (117/156, 75%) and blood pressure measurement (115/156, 74%).Conclusions Most patients reported being satisfied with the vascular access used for their treatment. Improved education and understanding about the evidence-based requirements for vascular access are needed. Perceived risk factors for lymphedema remain variable and are not evidence-based.