A port is a small, implantable medical device designed to provide long-term access to a patient’s bloodstream. Placed completely under the skin, it offers a convenient way to deliver medications, fluids, or draw blood samples over an extended period. Its design allows for repeated use without frequent needle sticks into peripheral veins.
Why a Port for Breast Cancer Treatment?
For individuals undergoing breast cancer treatment, especially chemotherapy, a port offers significant advantages. Chemotherapy drugs can be harsh on smaller, peripheral veins, causing irritation, damage, or scarring with repeated administration. Frequent needle sticks for infusions and blood draws also lead to discomfort, pain, and vein collapse.
A port provides reliable central venous access, delivering medications directly into a large vein, typically near the heart. This protects smaller veins from chemotherapy effects and reduces discomfort from multiple needle insertions. The device streamlines treatment, allowing efficient administration of chemotherapy, intravenous fluids, and blood products, and facilitates blood collection for lab tests.
Understanding Port Types and Placement
The most common type of port used in breast cancer treatment is the implantable port, often called a port-a-cath or mediport. This device consists of two main parts: a small reservoir (portal), typically made of metal or plastic, and a thin, flexible catheter. The reservoir has a raised center made of a self-sealing silicone material, known as the septum, where needles are inserted.
The entire system is surgically implanted under the skin, usually in the upper chest, about an inch below the collarbone. The catheter is then threaded into a large vein, such as the subclavian or jugular, with its tip positioned in the superior vena cava, a large vein near the heart. While less common, ports can also be placed in the upper arm.
Insertion, Access, and Ongoing Care
Port insertion is typically a minor outpatient surgical procedure, often performed under local anesthesia with some sedation. The surgeon makes small incisions to create a pocket for the port and access a vein. The catheter is then guided into the large vein, and the port is secured in the created pocket.
Once the port is in place and the incision sites have healed, healthcare professionals access it by inserting a special non-coring needle directly through the skin into the port’s septum. This allows for the administration of treatments or withdrawal of blood. To prevent blockages and maintain the port’s function, it requires routine flushing with a saline solution, usually once a month when not in active use. Patients should maintain hygiene around the site and monitor for signs of infection, such as redness, swelling, warmth, pain, or drainage at the port site.
Living with a Port and Removal
Living with an implanted port generally has minimal impact on daily activities. Once the incision heals, individuals can shower, bathe, and swim without concern, as the device is beneath the skin. While a small, inconspicuous bump may be felt, it rarely interferes. Some find a seatbelt causes pressure over the port, which can be alleviated with a small pillow or folded towel.
The port is typically removed once breast cancer treatment is complete and long-term venous access is no longer needed. Other reasons for removal include infection, malfunction, or discomfort. The removal procedure is similar to insertion, involving a small incision over the port site, often under local anesthesia. The port and catheter are extracted, and the incision is closed, usually with dissolvable stitches. Patients may experience mild discomfort for a few days.