Impact of port site scar on perception of patients with breast cancer: patient-reported outcomes

Abstract

Most patients are conscious of their port scars and if offered the choice choose placement in the arm rather than the chest. Upper extremity port placement should be further explored as an alternative approach for patients with breast cancer to improve port scar consciousness.

Exploring the impact of anterior chest wall scars from implantable venous ports in adolescent survivors of cancer

“…This suggests it might be difficult to identify in advance (i.e., at the time of port insertion) which patients might be most susceptible to distress from an anterior chest wall scar. Studies have shown among other populations that patients are rarely consulted about locations for their venous access devices, but that they do appreciate being part of the decision‐making process and being offered choice 9,10,12,24 . Currently, from these results, the evidence to prompt a change in the standard location for all ports is lacking.…”

“…Studies have shown among other populations that patients are rarely consulted about locations for their venous access devices, but that they do appreciate being part of the decision-making process and being offered choice. 9,10,12,24 Currently, from these results, the evidence to prompt a change in the standard location for all ports is lacking. Undertaking a discussion regarding the pros and cons of different sites prior to port placement could be considered, while being mindful of individual family stress levels when adding yet another decision at a time when many patients may be overwhelmed.…”

“…[5][6][7][8] When inserting a port, the location is usually determined by local surgical/radiological expertise, device availability, patient age, prior devices, venous patency, and less often by patients' opinions or preferences. [9][10][11] Acceptance of alternative locations for ports have been studied, mainly in adults (e.g., arm, lower lateral chest wall, inframammary, upper abdomen, thigh), with authors reporting on various outcomes (psychological, cosmetic, patient acceptability, impact on daily activities, ease of access). [9][10][11][12][13] There is no conclusive evidence of difference in port complication rates with different sites, but when complications occur, the causes can be multifactorial (vein in which catheter is placed, right or left side used, catheter material, insertion technique, indications, patient factors), and are not usually related to the site of the port pocket.…”

“…[9][10][11] Acceptance of alternative locations for ports have been studied, mainly in adults (e.g., arm, lower lateral chest wall, inframammary, upper abdomen, thigh), with authors reporting on various outcomes (psychological, cosmetic, patient acceptability, impact on daily activities, ease of access). [9][10][11][12][13] There is no conclusive evidence of difference in port complication rates with different sites, but when complications occur, the causes can be multifactorial (vein in which catheter is placed, right or left side used, catheter material, insertion technique, indications, patient factors), and are not usually related to the site of the port pocket. 11,[13][14][15][16] Given the paucity of data specific to survivors of childhood cancers, we sought to explore the perspective of teenage survivors of childhood cancer regarding their port scars and to determine whether an alternative location for ports is warranted.…”

“…Patients’ experiences and perceptions are increasingly recognized as important factors which influence distress from scarring 5–8 . When inserting a port, the location is usually determined by local surgical/radiological expertise, device availability, patient age, prior devices, venous patency, and less often by patients’ opinions or preferences 9–11 . Acceptance of alternative locations for ports have been studied, mainly in adults (e.g., arm, lower lateral chest wall, inframammary, upper abdomen, thigh), with authors reporting on various outcomes (psychological, cosmetic, patient acceptability, impact on daily activities, ease of access) 9–13 .…”