Breast
Port-a-cath insertion
A small device implanted under the skin of the chest that gives reliable access to a large vein. It is used where treatment such as chemotherapy will run over months, so that each session does not require a new cannula in the arm.
Who it is for
- Anyone starting a course of systemic chemotherapy expected to run over several months
- People whose arm veins are difficult to cannulate, or have become so during treatment
- Where repeated infusions, blood sampling or both are anticipated
- It is optional. Treatment can be given through a peripheral cannula, and some people prefer that
What to expect
Inserted under local anaesthetic with sedation, or under general anaesthetic, usually as a day case.
A small incision is made below the collarbone. The port sits under the skin and a fine catheter runs from it into a large vein.
Imaging is used during the procedure to confirm the catheter is correctly positioned before you leave.
Once healed, the port is accessed through the skin with a special needle. It is visible as a small raised disc and is not usually uncomfortable.
It stays in for as long as treatment requires, and is removed in a separate, smaller procedure afterwards.
Recovery
Most people go home the same day. The site is tender for several days and you will be told when the dressing can come off and when the port can first be used. Your team will explain what to look for, redness, swelling, fever, and who to contact if it appears.
Risks and possible complications
Every operation carries risk, and the list below is general rather than complete. Which of these matter for you depends on your health, your anatomy and what is being treated, which is what the consent conversation before surgery is for.
- Bleeding or bruising at the site, and infection, either of the wound or of the device itself, which sometimes means the port has to be removed
- Pneumothorax, air in the space around the lung, caused by the needle during insertion. Uncommon, and the reason imaging is used
- Clot forming in the vein around the catheter, which may need treatment and occasionally removal of the port
- Blockage of the catheter, which can usually be cleared but sometimes cannot
- The catheter moving out of position after insertion
- Skin over the port becoming thin or breaking down, particularly in people who are very slim or whose treatment affects healing
- A permanent scar below the collarbone, and a small visible contour where the port sits
No surgeon can promise a particular result, and nothing on this page should be read as one.
Still not sure whether it needs looking at?
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