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.ConclusionsIn 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.
Reference:Zhang M, Liu X, Ruan L, Pei X, Bi Q. Initial peripherally inserted central catheter tip position accuracy by puncture arm and associated factors in female patients with breast cancer: A retrospective cohort study. J Int Med Res. 2026 Sep;54(9):3000605261490822. doi: 10.1177/03000605261490822. Epub 2026 Sep 27. PMID: 42802165.