Dados do Resumo

Título

Types of Central Venous Access in Breast Cancer Patients and Their Associated Care

Introdução

In Brazil, according to the Ministry of Health, breast cancer is the leading cause of cancer-related death among women. Risk factors are divided into genetic, biological, and lifestyle factors. Early diagnosis is crucial for a favorable prognosis, enhancing the effectiveness of treatments, which may include chemotherapy, hormonal therapy, radiotherapy, and surgery. The success of central venous access (CVA) use depends on the patient's clinical condition and the duration of the treatment.

Objetivo

Compare the efficacy and safety of central venous access main methods for breast cancer patients chemotherapy. Evaluate methods safety and technic viability, focused on complications risk, aiming at a lower impact on life quality during treatment.

Métodos

This is a literature review study. A search was conducted in english on the PubMed database, covering review articles, retrospective studies, and randomized trials published in the last five years. The inclusion criteria for this review were articles involving patients with breast cancer that utilized Totally Implanted Vascular Access Devices (TIVAD) or Peripherally Inserted Central Catheters (PICC). The search strategy employed was as follows: ("TIVAD" OR "Totally Implanted Vascular Access Devices") OR ("PICC" OR "Peripherally Inserted Central Catheters") AND ("breast cancer" OR "mammary cancer"). A total of 72 results were found, of which six articles were selected based on the established inclusion criteria. Among the six selected articles, four were retrospective studies, one was a meta-analysis, and one was a randomized trial. Articles that did not align with the central theme were excluded from the analysis.

Resultados

A study of 570 patients with initial breast cancer showed that PICC had had a higher success rate than TIVAD (99,5% vs. 99,0%). In venous access choice, considered treatment duration, preferring TIVAD for prolonged use. In comparative of complications rate between arm portal and chest in this patient profile, it was concluded that there isn't significant difference, although the arm portal had showed to be safe, but with a higher thrombosis risk. A study compared access doors (PORTs) and PICCs catheters in therms of implantation and complications. Both had success in implantation, but PICCs had serious complications and more discomfort than PORTs, resulting in a higher risk with PICCs. In another approach, the TIVAPs insertion guided by ultrasound via innominate vein had 95,92% of success in the first puncture, with 1,50% of perioperative complications and 4,48% of postoperative, without catheter rupture or bad positioning.

Conclusões

In summary, different methods of central venous access (CVA) demonstrate varied profile of safety and efficacy. The dispositive choice must be personalized, considering treatment duration, patient's clinical profile and health team's experience, optimizing the clinic management and the life quality of breast cancer patients in chemotherapy treatment. These findings highlight the necessity of a judicious and individualized approach in central venous access choice.

Palavras Chave

Cancer de mama; Breast cancer; Breast Neoplasms