A Single-Institution Audit of Chemo-PORT Placements During Breast Surgery with Literature Review for Management of Common Complications

Abstract Most breast cancer patients need chemotherapy for a duration of 3–12 months. The morbidity of frequent intravenous access, mainly on the contralateral upper limb is troublesome and chemo-PORT placement is helpful. We analysed a prospective database of patients who had concurrent chemo-PORT placement with breast surgery between January-2019 and December-2023 at our centre for their complication rate. Clinico-pathological data was collected from electronic medical records and analysed in SPSS-V25. A total of 408 breast cancer patients underwent chemo-PORT placement. The median age of cohort was 50 years(18–78). Breast conservation surgery was done in 201(49.3%), 207(51.7%) had mastectomy. Of 408, 195(47.8%) patients had per primum surgery, 126(30.9%), 26(6.4%) and 61(15%) were operated post-1st line chemotherapy, in the recurrent setting and for second breast primary respectively. 260(63.7%) were HER2 positive, 73 ER/PgR + (17.9%) and 75(18.4%) TNBC. Total 256(62.7%) patients received anti-HER2 therapy. The overall complication rate was 12.5%(51/408). Procedural/immediate complications were seen in 3/408(0.7%) patients which included pericardial placement, pleural cavity placement with haemothorax, and intra-operative guidewire migration in 1 patient each. Post-procedural complications were further sub-classified- as short-term complications that included PORT site hematomas in 3/408(0.7%), pocket-site infections in 4/408(0.9%); and long-term complications that included catheter-related bloodstream infections in 13/408(3.2%), catheter related thrombosis in 7/408(1.7%), persistent withdrawal occlusion in 14/408(3.4%), and catheter displacement in 7/408(1.7%).Chemo-PORT placement is an efficient and safe way of administering chemotherapy in breast cancer patients with < 1% serious complication rate. However, timely identification of serious complications can prevent a catastrophe.