Initial peripherally inserted central catheter tip position accuracy by puncture arm and associated factors in female patients with breast cancer: A retrospective cohort study
- 1School of Nursing, Anhui Medical University, China
- 2Interventional Department, Second Ward, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, P.R. China
Abstract
Objective: To examine the association between puncture arm and initial peripherally inserted central catheter tip positioning accuracy in female breast cancer patients and to explore related factors associated with malposition.
Methods: This retrospective cohort study included 402 female breast cancer patients undergoing chemotherapy requiring peripherally inserted central catheter placement. Patients were categorized into left-arm and right-arm groups. Demographic, clinical, and operator variables were analyzed. Pre-procedural anxiety status was evaluated using the Perioperative Anxiety Scale-7. Placement accuracy was assessed radiographically. Multivariate logistic regression identified independent predictors, and model performance was evaluated using receiver operating characteristic curve analysis.
Results: In the matched cohort, initial tip accuracy was higher in the right-arm group (90.4%) than in the left-arm group (80.8%; P = 0.013). Left-arm selection, advanced age, compromised vascular condition, high pre-procedural anxiety, and limited operator experience were identified as independent factors associated with initial tip accuracy (P < 0.05). The multivariable descriptive model showed an apparent area under the curve of 0.825.
Conclusions: In this single-center retrospective cohort, right-arm puncture was associated with higher initial peripherally inserted central catheter tip positioning accuracy than left-arm puncture in female breast cancer patients. However, because breast cancer-specific factors influencing arm selection, including surgery laterality and axillary lymph node management, radiotherapy, and lymphedema-related factors, were not systematically collected, this association should not be interpreted as a causal effect of puncture side alone. These findings are hypothesis-generating and underscore the need for individualized peripherally inserted central catheter planning that considers clinical feasibility, venous condition, patient anxiety, treatment-related arm-selection factors, and operator experience.
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BibTeX
@article{zhang2026initial,
title = {{Initial peripherally inserted central catheter tip position accuracy by puncture arm and associated factors in female patients with breast cancer: A retrospective cohort study}},
author = {Min Zhang and Xue Liu and Lu Ruan and Xiaohong Pei and Qingquan Bi},
journal = {The Journal of International Medical Research},
year = {2026},
month = sep,
doi = {10.1177/03000605261490822},
url = {https://doi.org/10.1177/03000605261490822},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Initial peripherally inserted central catheter tip position accuracy by puncture arm and associated factors in female patients with breast cancer: A retrospective cohort study
AU - Min Zhang
AU - Xue Liu
AU - Lu Ruan
AU - Xiaohong Pei
AU - Qingquan Bi
PY - 2026
DA - 2026/09/27
JO - The Journal of International Medical Research
DO - 10.1177/03000605261490822
UR - https://doi.org/10.1177/03000605261490822
AB - Objective: To examine the association between puncture arm and initial peripherally inserted central catheter tip positioning accuracy in female breast cancer patients and to explore related factors associated with malposition. Methods: This retrospective cohort study included 402 female breast cancer patients undergoing chemotherapy requiring peripherally inserted central catheter placement. Patients were categorized into left-arm and right-arm groups. Demographic, clinical, and operator variables were analyzed. Pre-procedural anxiety status was evaluated using the Perioperative Anxiety Scale-7. Placement accuracy was assessed radiographically. Multivariate logistic regression identified independent predictors, and model performance was evaluated using receiver operating characteristic curve analysis. Results: In the matched cohort, initial tip accuracy was higher in the right-arm group (90.4%) than in the left-arm group (80.8%; P = 0.013). Left-arm selection, advanced age, compromised vascular condition, high pre-procedural anxiety, and limited operator experience were identified as independent factors associated with initial tip accuracy (P < 0.05). The multivariable descriptive model showed an apparent area under the curve of 0.825. Conclusions: In this single-center retrospective cohort, right-arm puncture was associated with higher initial peripherally inserted central catheter tip positioning accuracy than left-arm puncture in female breast cancer patients. However, because breast cancer-specific factors influencing arm selection, including surgery laterality and axillary lymph node management, radiotherapy, and lymphedema-related factors, were not systematically collected, this association should not be interpreted as a causal effect of puncture side alone. These findings are hypothesis-generating and underscore the need for individualized peripherally inserted central catheter planning that considers clinical feasibility, venous condition, patient anxiety, treatment-related arm-selection factors, and operator experience.
SN - 0300-0605
SN - 1473-2300
ER -