Time to rethink vascular access in patients with breast cancer.

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  • Author(s): McDiarmid, Sheryl; Larocque, Gail
  • Source:
    British Journal of Nursing (BR J NURS), 7/23/2020; 29(14): S32-S38. (7p)
  • Publication Type:
    Article - pictorial, tables/charts
  • Language:
    English
  • Additional Information
    • Affiliation:
      Advanced Practice Nurse in the Corporate Vascular Access, Apheresis and Blood and Marrow Transplant Programs at The Ottawa Hospital. She has presented and published extensively on all areas of her clinical expertise. Sheryl is the past President of the Canadian Vascular Access Association
      Nurse Practitioner (NP) in the Wellness Beyond Cancer Program, at the Ottawa Regional Cancer Centre. She completed her Nurse Practitioner's program at the University of Ottawa, and her Masters of Nursing at Charles Sturt University, New South Wales, Australia
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      Breast cancer management is a rapidly evolving field. Diagnosis and treatment options have changed dramatically over the years, as have options for vascular access devices used to administer therapies. We now need to critically rethink vascular access device options for our breast cancer patients. Breast cancer (BC) is the most commonly diagnosed cancer among Canadian women. Although BC incidence continues to rise, the overall mortality rate in Canada is the lowest it has been for 70 years. The five-year net survival is 87%, and 83% of women are alive at 10 years. New oral therapies, shorter dose-dense treatments, and decreased use of anthracycline-base regimens are reducing the need for central venous access devices during acute treatment phases. However, these survivors go on to develop other health issues requiring routine venipuncture and insertion of vascular access devices. Breast cancer-related lymphedema (BCRL) is a chronic complication that has no cure and no proven prevention strategies. Approximately 21% of breast cancer survivors are at risk of developing BCRL. Of those patients who do develop BCRL, 70% do so within two years of surgery, 90% within three years, and another one percent per year thereafter. The literature supports axillary lymph node dissection, mastectomy, administration of chemotherapy or radiotherapy, and obesity, as risk factors for the development of BCRL. However, 40% of patients who develop BCRL have no identifiable risk factors. Broader risk reduction strategies developed are not evidence based, the most commonly cited being avoidance of needle sticks. Large cohort studies have found no significant association between blood draws and intravenous infusion in the surgical arm with the development of BCRL. Recommendations that effectively eliminate vascular access on the surgical side for the patient's entire lifetime are neither necessary nor realistic. Vascular access specialists can provide leadership by developing standardized, evidence-informed recommendations for safe vascular access and infusion practices for this patient population.
    • Journal Subset:
      Core Nursing; Double Blind Peer Reviewed; Editorial Board Reviewed; Europe; Expert Peer Reviewed; Nursing; Peer Reviewed; UK & Ireland
    • ISSN:
      0966-0461
    • MEDLINE Info:
      NLM UID: 9212059
    • Publication Date:
      20200730
    • Publication Date:
      20200804
    • DOI:
      10.12968/bjon.2020.29.14.S32
    • Accession Number:
      144711758
  • Citations
    • ABNT:
      MCDIARMID, S.; LAROCQUE, G. Time to rethink vascular access in patients with breast cancer. British Journal of Nursing, [s. l.], v. 29, n. 14, p. S32–S38, 2020. DOI 10.12968/bjon.2020.29.14.S32. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=144711758. Acesso em: 30 set. 2020.
    • AMA:
      McDiarmid S, Larocque G. Time to rethink vascular access in patients with breast cancer. British Journal of Nursing. 2020;29(14):S32-S38. doi:10.12968/bjon.2020.29.14.S32
    • APA:
      McDiarmid, S., & Larocque, G. (2020). Time to rethink vascular access in patients with breast cancer. British Journal of Nursing, 29(14), S32–S38. https://doi.org/10.12968/bjon.2020.29.14.S32
    • Chicago/Turabian: Author-Date:
      McDiarmid, Sheryl, and Gail Larocque. 2020. “Time to Rethink Vascular Access in Patients with Breast Cancer.” British Journal of Nursing 29 (14): S32–38. doi:10.12968/bjon.2020.29.14.S32.
    • Harvard:
      McDiarmid, S. and Larocque, G. (2020) ‘Time to rethink vascular access in patients with breast cancer’, British Journal of Nursing, 29(14), pp. S32–S38. doi: 10.12968/bjon.2020.29.14.S32.
    • Harvard: Australian:
      McDiarmid, S & Larocque, G 2020, ‘Time to rethink vascular access in patients with breast cancer’, British Journal of Nursing, vol. 29, no. 14, pp. S32–S38, viewed 30 September 2020, .
    • MLA:
      McDiarmid, Sheryl, and Gail Larocque. “Time to Rethink Vascular Access in Patients with Breast Cancer.” British Journal of Nursing, vol. 29, no. 14, July 2020, pp. S32–S38. EBSCOhost, doi:10.12968/bjon.2020.29.14.S32.
    • Chicago/Turabian: Humanities:
      McDiarmid, Sheryl, and Gail Larocque. “Time to Rethink Vascular Access in Patients with Breast Cancer.” British Journal of Nursing 29, no. 14 (July 23, 2020): S32–38. doi:10.12968/bjon.2020.29.14.S32.
    • Vancouver/ICMJE:
      McDiarmid S, Larocque G. Time to rethink vascular access in patients with breast cancer. British Journal of Nursing [Internet]. 2020 Jul 23 [cited 2020 Sep 30];29(14):S32–8. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=144711758