From the Research
It is recommended to place an intravenous (IV) line on the side of a mastectomy if necessary, as the risk of complications is similar to placing it on the contralateral side, according to a recent study published in 2021 1. The study found that the frequency of complications was not significantly different between IV placements in the ipsilateral and contralateral arms, with an incidence of 3.9 per 10,000 and 7.3 per 10,000, respectively. Key points to consider when deciding on IV placement in patients with a history of mastectomy include:
- The risk of lymphedema, infection, and impaired circulation in the affected arm is a concern, but the study suggests that IV placement on the ipsilateral side does not significantly increase this risk 1.
- If IV placement on the mastectomy side is necessary, the most distal site possible should be selected to minimize risk.
- Healthcare providers should document the rationale for using the mastectomy side and monitor closely for complications.
- The study's findings are consistent with the goal of minimizing morbidity, mortality, and improving quality of life for patients with a history of mastectomy. Some studies have investigated the effects of mastectomy on lymphedema and venous changes, but the most recent and highest-quality study suggests that IV placement on the ipsilateral side is not contraindicated 1. Other studies have explored the use of noninvasive assessments to detect postmastectomy lymphedema, but these findings do not directly impact the decision on IV placement 2. In summary, the placement of an IV line on the side of a mastectomy is not necessarily contraindicated, and the decision should be based on individual patient needs and careful risk-benefit assessment.