ORIGINAL RESEARCH article
Front. Oncol.
Sec. Surgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1684119
This article is part of the Research TopicRedefining Care: Integrating Surgical Innovations and Precision Medicine in Breast Cancer TreatmentView all 6 articles
Ultrasound-guided axillary vein versus internal jugular vein access for totally implantable venous access ports in breast cancer: a retrospective comparison of patient-reported outcomes
Provisionally accepted
- Department of Vascular Surgery & Interventional Therapy, Fujian Provincial Maternity and Children's Hospital, Fuzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Patient-centered venous access is critical in breast cancer supportive care. While the tunnel-less axillary vein (AxV) approach for totally implantable venous access port (TIVAP) implantation may improve patient experience, comparative evidence on patient-reported outcomes (PROs) against the standard internal jugular vein (IJV) approach remains limited. Methods: This single-center retrospective cohort study compared ultrasound-guided IJV (n=106) versus AxV (n=102) TIVAP implantation in breast cancer patients (September 2020-February 2025). Primary outcomes included postoperative comfort (assessed at 1 day), and cosmetic outcome and satisfaction (assessed at 6 months). Complications were monitored for 6 months. Group comparisons utilized chi-square/Fisher's exact tests. To control for potential confounders, multivariable logistic regression analyses were performed, adjusting for age, body mass index, and implantation side. Complications were monitored for 6 months. Results: The AxV approach significantly enhanced early postoperative comfort, with a higher rate of no discomfort (Grade 0: 72.5% vs. 59.4%, p=0.032). At 6 months, AxV demonstrated superior favorable cosmetic outcomes (Grades 1-2: 93.1% vs. 67.9%, p<0.001) and higher overall satisfaction (94.1% vs. 85.8%, p=0.039). Multivariable analysis confirmed the AxV approach as an independent predictor for ideal comfort (aOR=4.48, p=0.0002), favorable cosmetic outcome (aOR=6.22, p<0.001), and overall satisfaction (aOR=3.07, p=0.033). More AxV patients would choose the port again (83.3% vs. 72.6%, p=0.045). The overall complication rates were comparable between groups (4.8%, 0.269/1000 CD vs. 4.9%, 0.279/1000 CD; p=0.957). Conclusion: For breast cancer patients, the ultrasound-guided AxV approach for TIVAP provides superior early postoperative comfort, long-term cosmetic results, and patient satisfaction without increasing early complication risks, representing a significant patient-centered advancement in venous access.
Keywords: Axillary vein access, Totally implantable venous access port, breast cancer, patient-reported outcomes, comfort, Cosmetic result, Satisfaction
Received: 12 Aug 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 HE, Zhang, Cai, Chen and Zhan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tenghui Zhan, zhantenghui@fjsfy.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.