When to Consider a Chemo Port for Breast Cancer

As part of the treatment regimen for breast cancer, your oncologist (cancer specialist) may prescribe chemotherapy. Chemotherapy refers to medications that are often given intravenously (through an IV in a vein) to kill cancer cells. One of the ways chemotherapy can be administered is through a chemo port.

A chemo port is a device that’s implanted under the skin. It allows for the transmission of chemotherapy and other fluids into the bloodstream. The port of the device is attached to a catheter (a thin tube), which is threaded through a large vein in the chest.

This entire device is placed under the skin and is accessed through a special needle. Once accessed, the chemo port can be used to remove blood for testing or to administer fluids.

This article will review how a chemo port works and why it’s recommended, as well as other facts to know about having this device.

When It’s Recommended for Breast Cancer

Getting chemotherapy for breast cancer often requires multiple medications given at scheduled intervals. This can mean being stuck repeatedly with a needle to get an IV in place.

Some people with difficult-to-access veins may undergo multiple attempts to insert a needle into the skin. With a chemo port, however, the catheter tubing is always in place, and the access is made through the port without having to have a needle placed each time.

Because the components of a port are contained entirely within the body, there is less risk of infection.

Another reason a chemo port may be used is that some chemotherapy medications are very irritating to the veins. Referred to as vesicants, these medications can cause significant damage to the tissue surrounding the vein if they leak out. Medications used for the treatment of breast cancer include:

• Adriamycin (doxorubicin)
• Ellence (epirubicin)
• Taxol (paclitaxel)

When given through a chemo port, the risk of these medications leaking out of the vein and into the surrounding tissue is lowered. It is possible that even with a chemo port, there can be leaking, so it’s important that qualified nurses give these medications.

Once placed, the chemo port can stay in permanently as long as it’s cared for properly. 

Placement

The chemo port is usually placed by an interventional radiologist or a surgeon. Because it is a surgical procedure, it is done in a sterile environment while the patient is under anesthesia. Once you’ve received anesthesia and you’re placed into the proper position, your skin will be cleaned and prepared for insertion of the chemo port.

There will be a small incision in the neck, where the vein will be accessed. There will also be an incision in the upper chest and a small pocket formed where the chemo port will be placed.

Once placement has been verified, the incisions will be closed, using either stitches or skin glue, and a bandage placed on the skin. Sometimes a chest X-ray will be done after the procedure to make sure the chemo port is in place.

After the procedure, you’ll be moved to a recovery area, where you’ll be monitored as you awaken from anesthesia and your vital signs will be taken. Once the healthcare team feels it is safe, you will be discharged home.

Removal

Removing a chemo port is done with a minor procedure. Chemo ports may be removed because the prescribed chemotherapy regimen is complete or there is a  complication with the chemo port, such as an infection that develops or a failure of the device to function properly. 

The port removal process is usually done in the same department that placed the device. You usually will be under anesthesia. The skin is cleaned and prepared once anesthesia is given, and an incision is made at the location of the chemo port. The port is gently removed, followed by the catheter tubing.

The surgeon or radiologist will repair the blood vessel where the catheter was located and then close the skin where the port was removed with either stitches or skin glue.

Once fully awakened after the anesthesia wears off, you will be allowed to go home. 

Daily Life With a Chemo Port 

Once it is placed, the chemo port is hidden completely under the skin. Unless there is a needle in place, no part of the chemo port is visible from the outside. There may be a slight bump under the skin where the port is located. Depending upon the person's size, it may be more visible in some people than others.

While the incision is healing, it is important to follow all of the instructions given to you by the surgical team who placed the port. They will provide specific information on when the area can get wet during bathing or when it is safe to swim. 

Once the skin has healed completely, there will be little to no restrictions needed because of the chemo port. Sometimes people with a chemo port find car seat belts irritating if they cover the area where the port is located. A small pillow or folded towel between the belt and the skin can make car rides more comfortable. 

The chemo port should only be accessed by people trained to do so, such as the members of your oncology team. Do not put a needle directly into the port yourself. The skin must be cleaned properly, and all instruments used to access the chemo port must be sterile to reduce the risk of infection.

Other Ways to Get Chemotherapy 

In addition to chemo ports, chemotherapy can be given without one. The other forms of access can include a peripheral IV, a peripherally inserted central catheter (PICC), or a central line. 

Peripheral IV

A peripheral IV is the traditional placement of a line. The peripheral IV, often referred to as just an IV, usually is inserted into a vein in the skin of the hand or arm.

It can only be used for a few days before it needs to be removed. It’s a convenient option if chemotherapy is given infrequently or if the medications aren’t irritating to the veins.

PICC

A PICC line is a type of venous access placed into a vein in the upper arm. This does not require anesthesia to be placed ,but a local anesthetic often is given where the PICC line will be placed.

The length of the PICC line is much longer than a standard IV and goes into a bigger vein that is deeper in the arm. It can be left in for weeks, and chemotherapy that is irritating to the vein can be given through it. Part of the PICC line is out of the arm at all times and is covered by a dressing.

Central Line

Another type of IV access is called a central line (sometimes called a Hickman catheter or tunneled catheter). This type of catheter is usually placed in a vein near the collarbone or a vein in the neck.

The catheter is inserted into the vein and threaded through a few inches. The remaining part of the catheter is present outside of the body, similar to a PICC line. Sedation may be given when placing this line.

Summary 

Chemo ports are a popular option for chemotherapy. Some chemotherapy medications are safe to administer through a regular IV, while others can cause damage to the vein and need more secure IV access.

A chemo port is implanted under the skin of the upper chest and connected to a large vein. A surgical procedure is performed to place the port. It can remain in place for an extended time and be removed by a surgical procedure.

A Word From Verywell 

You may be a little nervous about having a chemo port placed for treatment for breast cancer. Remember that this is done to deliver chemotherapy in the safest way possible. Be sure to follow all of the instructions that are given to you. Contact your oncology team if you ever have concerns about how the chemo port looks or feels.