Totally implantable venous access port implantation in a breast cancer patient with situs inversus totalis - A case report

Sep 23, 2026

Uploaded by Mary Man

Situs inversus totalis is a rare congenital condition involving complete mirror-image transposition of thoracic and abdominal organs. A 60-year-old woman with a 5-year history of left breast nodules was admitted; contrast-enhanced breast MRI and abdominal ultrasound confirmed left breast cancer with situs inversus totalis. Preimplantation CT showed the left internal jugular vein followed a straighter course to the right atrium than the right side. Under ultrasound guidance, a totally implantable venous access port was successfully placed via the left internal jugular vein. Neoadjuvant taxotere adriblastina cyclophosphamide chemotherapy was then administered before modified radical mastectomy.

LanguageEnglish

CategoryHealthcare

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Abstract

Background

Case report

Totally implantable venous access port implantation in a breast cancer patient with situs inversus totalis: A case report Journal of International Medical Research 1–5 © The Author(s) 2026 Article reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/03000605261463636](DOI: 10.1177/03000605261463636)[ ](DOI: 10.1177/03000605261463636)[journals.sagepub.com/home/imr](journals.sagepub.com/home/imr) Xuan Shao 1 , Danying Xu 1,2, Wuzhen Chen 1, Liwei Pang 1 and Jian Huang 1 Abstract Situs inversus totalis, a rare congenital condition characterized by complete mirror-image transposition of the thoracic and abdominal organs, has not previously been reported in patients with breast cancer. A 60-year-old woman with a 5-year history of left breast nodules was admitted. Contrast-enhanced breast magnetic resonance imaging and abdominal ultrasound revealed mirror-image transposition of the thoracic and abdominal organs. The patient was diagnosed with left breast cancer concomitant with situs inversus totalis. Preimplantation computed tomography revealed that the left internal jugular vein followed a straighter course to the right atrium than the right internal jugular vein. Under ultrasound guidance, a totally implantable venous access port was successfully placed via the left internal jugular vein. Neoadjuvant taxotere adriblastina cyclophosphamide chemotherapy was subsequently administered through the totally implantable venous access port before the patient underwent modiﬁed radical mastectomy for left breast cancer. Given the mirror-image anatomy, the anatomically relocated left internal jugular vein should be preferentially selected for totally implantable venous access port placement because of its more favorable anatomical course compared with the right internal jugular vein. To the best of our knowledge, this is the ﬁrst reported case of totally implantable venous access port implantation in a patient with breast cancer and concurrent situs inversus totalis. Keywords Situs inversus totalis, imaging modalities, totally implantable venous access port, breast cancer, left internal jugular vein, neoadjuvant chemotherapy, case report Received: 20 February 2026; revised: 1 June 2026; accepted: 9 June 2026 Background According to GLOBOCAN 2020, female breast cancer is the most commonly diagnosed cancer worldwide and the fourth leading cause of cancer-related mortality.1 In China, the age-standardized 5-year survival rate for female breast cancer was estimated at 81 .0% during 2019–2021, demonstrating a clear upward trend over time.2 The pathogenesis of breast cancer has been extensively studied and involves genetic alternations, changes in hormonal homeostasis, and immune interference.3–7 First-line treatment strategies for breast cancer include surgical resection, chemotherapy, and multimodal combination therapy.8 Neoadjuvant chemotherapy is recommended for patients with triple- 1 Department of Breast Surgery, The Second Afﬁliated Hospital, Zhejiang University School of Medicine, China 2Department of Breast Surgery, The Second Hospital of Jiaxing, China Corresponding authors: Xuan Shao, Department of breast surgery, The Second Afﬁliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China. Email: [neoonc2018@zju.edu.cn](neoonc2018@zju.edu.cn) Jian Huang, Department of breast surgery, The Second Afﬁliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China. Email: [drhuangjian@zju.edu.cn](drhuangjian@zju.edu.cn) Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution NonCommercial 4.0 License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)) which permits non-commercial use, reproduction and distribution of the work without further permission

FAQs

What condition was present alongside breast cancer in this case?

The patient had situs inversus totalis, a rare congenital mirror-image transposition of the thoracic and abdominal organs, alongside left breast cancer.

How was the venous access port placement planned before surgery?

Preimplantation computed tomography assessed the internal jugular veins and showed the left internal jugular vein had a more favorable course to the right atrium.

Why was the left internal jugular vein chosen for port implantation?

Because the anatomically relocated left internal jugular vein provided a straighter, more favorable anatomical course compared with the right internal jugular vein.

Sep 23, 2026

Uploaded by Mary Man