Implantable Ports vs Peripherally Inserted Central Catheters in Breast Cancer Chemotherapy: A Comprehensive Meta-Analysis.

Abstract

BACKGROUND Reliable venous access is critical for breast cancer chemotherapy, yet the optimal choice between peripherally inserted central catheters (PICC) and implantable port catheters (IPC) remains unclear. This meta-analysis compares complication risks associated with these devices in patients with breast cancer. MATERIAL AND METHODS A systematic review of randomized controlled trials and observational studies was conducted using EMBASE, Cochrane Library, PubMed, and ScienceDirect (up to March 2025). Inclusion criteria focused on patients with breast cancer receiving chemotherapy, with outcomes including thrombosis, infection, and catheter-related complications. Five studies (n=1125 patients) were analyzed using the R software, with pooled risk ratios (RR) and 95% confidence intervals (CI) calculated. Publication bias, as assessed by Egger's and Begg's tests, and heterogeneity (I²) were evaluated, and a leave-one-out sensitivity analysis was conducted to examine the robustness of the pooled effect estimates. The quality of the included studies was assessed using the ROBINS-I, Jadad scale, and GRADE tools. P<0.05 was considered as statistically significant. RESULTS Pooled analysis demonstrated an increased complication risk with PICC, compared with IPC (RR=1.75, 95% CI: 1.24-2.46), driven by higher thrombosis and infection rates. No publication bias (Egger's P=0.411; Begg's P=0.624) was observed. Two large studies showed statistically significant risks, favoring IPC, while smaller studies reported non-significant trends. CONCLUSIONS IPC is associated with fewer complications in patients with breast cancer undergoing chemotherapy, particularly for non-short-term treatment. Clinical decisions should prioritize IPC for high-risk patients. These findings advocate for IPC use in updated clinical guidelines to enhance safety and outcomes in breast cancer treatment.