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Optimizing Vascular Access for Patients Receiving Intravenous Systemic Therapy for Early-Stage Breast Cancer—A Survey of Oncology Nurses and Physicians
 
 
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Current Oncology
Volume 25
Issue 4
10.3747/co.25.3911
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

Perceptions of Vascular Access for Intravenous Systemic Therapy and Risk Factors for Lymphedema in Early-Stage Breast Cancer—A Patient Survey

by
N. LeVasseur
1,
C. Stober
2,
M. Ibrahim
1,
S. Gertler
1,
J. Hilton
1,2,
A. Robinson
3,
S. McDiarmid
4,
D. Fergusson
2,5,
S. Mazzarello
2,
B. Hutton
2,5,
A.A. Joy
6,
M. McInnes
2,7 and
M. Clemons
1,2,5,*
1
Division of Medical Oncology and Department of Medicine, The Ottawa Hospital and University of Ottawa, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada
2
The Ottawa Hospital Research Institute, Ottawa, ON, Canada
3
Division of Medical Oncology, Cancer Centre of Southeastern Ontario, Kingston, ON, Canada
4
Department of Nursing, The Ottawa Hospital, Ottawa, ON, Canada
5
Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
6
Department of Oncology, Division of Medical Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, Canada
7
Department of Radiology, University of Ottawa, Ottawa, ON, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2018, 25(4), 305-310; https://doi.org/10.3747/co.25.3911
Submission received: 2 May 2018 / Revised: 3 June 2018 / Accepted: 5 July 2018 / Published: 1 August 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 (183 evaluable 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.
Keywords: early-stage breast cancer; patient surveys; vascular access early-stage breast cancer; patient surveys; vascular access

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MDPI and ACS Style

LeVasseur, N.; Stober, C.; Ibrahim, M.; Gertler, S.; Hilton, J.; Robinson, A.; McDiarmid, S.; Fergusson, D.; Mazzarello, S.; Hutton, B.; et al. Perceptions of Vascular Access for Intravenous Systemic Therapy and Risk Factors for Lymphedema in Early-Stage Breast Cancer—A Patient Survey. Curr. Oncol. 2018, 25, 305-310. https://doi.org/10.3747/co.25.3911

AMA Style

LeVasseur N, Stober C, Ibrahim M, Gertler S, Hilton J, Robinson A, McDiarmid S, Fergusson D, Mazzarello S, Hutton B, et al. Perceptions of Vascular Access for Intravenous Systemic Therapy and Risk Factors for Lymphedema in Early-Stage Breast Cancer—A Patient Survey. Current Oncology. 2018; 25(4):305-310. https://doi.org/10.3747/co.25.3911

Chicago/Turabian Style

LeVasseur, N., C. Stober, M. Ibrahim, S. Gertler, J. Hilton, A. Robinson, S. McDiarmid, D. Fergusson, S. Mazzarello, B. Hutton, and et al. 2018. "Perceptions of Vascular Access for Intravenous Systemic Therapy and Risk Factors for Lymphedema in Early-Stage Breast Cancer—A Patient Survey" Current Oncology 25, no. 4: 305-310. https://doi.org/10.3747/co.25.3911

APA Style

LeVasseur, N., Stober, C., Ibrahim, M., Gertler, S., Hilton, J., Robinson, A., McDiarmid, S., Fergusson, D., Mazzarello, S., Hutton, B., Joy, A. A., McInnes, M., & Clemons, M. (2018). Perceptions of Vascular Access for Intravenous Systemic Therapy and Risk Factors for Lymphedema in Early-Stage Breast Cancer—A Patient Survey. Current Oncology, 25(4), 305-310. https://doi.org/10.3747/co.25.3911

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