Korean Journal of Radiology

  • 제25권2호
  • /
  • Pages.157-165
  • /
  • 2024
  • /
  • 1229-6929(pISSN)
  • /
  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
DOI QR코드

DOI QR Code

Hemorrhagic Complications Following Ultrasound-Guided Breast Biopsy: A Prospective Patient-Centered Study

  • Heera Yoen (Department of Radiology, Seoul National University Hospital) ;
  • Hyun-Ah Chung (Department of Radiology, Seoul National University Hospital) ;
  • So-Min Lee (Department of Radiology, Seoul National University Hospital) ;
  • Eun-sung Kim (Department of Radiology, Seoul National University Hospital) ;
  • Woo Kyung Moon (Department of Radiology, Seoul National University Hospital) ;
  • Su Min Ha (Department of Radiology, Seoul National University Hospital)
  • 투고 : 2023.09.10
  • 심사 : 2023.11.29
  • 발행 : 2024.02.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: We aimed to evaluate the clinical and imaging factors associated with hemorrhagic complications and patient discomfort following ultrasound (US)-guided breast biopsy. Materials and Methods: We prospectively enrolled 94 patients who were referred to our hospital between June 2022 and December 2022 for US-guided breast biopsy. After obtaining informed consent, two breast radiologists independently performed US-guided breast biopsy and evaluated the imaging findings. A hemorrhagic complication was defined as the presence of bleeding or hematoma on US. The patients rated symptoms of pain, febrile sensation, swelling at the biopsy site, and dyspnea immediately, 20 minutes, and 2 weeks after the procedure on a visual analog scale, with 0 for none and 10 for the most severe symptoms. Additional details recorded included those of nausea, vomiting, bleeding, bruising, and overall satisfaction score. We compared the clinical symptoms, imaging characteristics, and procedural features between patients with and those without hemorrhagic complications. Results: Of 94 patients, 7 (7%) developed hemorrhagic complications, while 87 (93%) did not. The complication resolved with 20 minutes of manual compression, and no further intervention was required. Vascularity on Doppler examination (P = 0.008), needle type (P = 0.043), and lesion location (P < 0.001) were significantly different between the groups. Patients with hemorrhagic complications reported more frequent nausea or vomiting than those without hemorrhagic complications (29% [2/7] vs. 2% [2/87], respectively; P = 0.027). The overall satisfaction scores did not differ between the two groups (P = 0.396). After 2 weeks, all symptoms subsided, except bruising (50% 2/4 in the complication group and 25% [16/65] in the no-complication group). Conclusion: US-guided breast biopsy is a safe procedure with a low complication rate. Radiologists should be aware of hemorrhagic complications, patient discomfort, and overall satisfaction related to this procedure.

키워드

과제정보

We thank Min-Ju Kim, for helping us with the statistical analysis, affiliated to the department of clinical epidemiology and biostatistics, Asan Medical Center.

참고문헌

  1. Helbich TH, Matzek W, Fuchsjager MH. Stereotactic and ultrasound-guided breast biopsy. Eur Radiol 2004;14:383-393 
  2. Burbank F. Stereotactic breast biopsy: comparison of 14- and 11-gauge Mammotome probe performance and complication rates. Am Surg 1997;63:988-995 
  3. Newell MS, Mahoney MC. Ultrasound-guided percutaneous breast biopsy. Tech Vasc Interv Radiol 2014;17:23-31 
  4. Parker SH, Klaus AJ. Performing a breast biopsy with a directional, vacuum-assisted biopsy instrument. Radiographics 1997;17:1233-1252 
  5. Fang M, Liu G, Luo G, Wu T. Feasibility and safety of image-guided vacuum-assisted breast biopsy: a PRISMA-compliant systematic review and meta-analysis of 20 000 population from 36 longitudinal studies. Int Wound J 2019;16:1506-1512 
  6. Goudreau S, Grimm LJ, Srinivasan A, Net J, Yang R, Dialani V, et al. Bleeding complications after breast core-needle biopsy-an approach to managing patients on antithrombotic therapy. J Breast Imaging 2022;4:241-252 
  7. Bruening W, Fontanarosa J, Tipton K, Treadwell JR, Launders J, Schoelles K. Systematic review: comparative effectiveness of core-needle and open surgical biopsy to diagnose breast lesions. Ann Intern Med 2010;152:238-246 
  8. Parker SH, Burbank F, Jackman RJ, Aucreman CJ, Cardenosa G, Cink TM, et al. Percutaneous large-core breast biopsy: a multi-institutional study. Radiology 1994;193:359-364 
  9. Brenner RJ, Fajardo L, Fisher PR, Dershaw DD, Evans WP, Bassett L, et al. Percutaneous core biopsy of the breast: effect of operator experience and number of samples on diagnostic accuracy. AJR Am J Roentgenol 1996;166:341-346 
  10. Del Turco MR, Ponti A, Bick U, Biganzoli L, Cserni G, Cutuli B, et al. Quality indicators in breast cancer care. Eur J Cancer 2010;46:2344-2356 
  11. Dahabreh IJ, Wieland LS, Adam GP, Halladay C, Lau J, Trikalinos TA. Core needle and open surgical biopsy for diagnosis of breast lesions: an update to the 2009 report. Rockville, MD: Agency for Healthcare Research and Quality (US), 2014 
  12. Soo MS, Shelby RA, Johnson KS. Optimizing the patient experience during breast biopsy. J Breast Imaging 2019;1:131-138 
  13. Wong TT, Cheung PS, Ma MK, Lo GG. Experience of stereotactic breast biopsy using the vacuum-assisted core needle biopsy device and the advanced breast biopsy instrumentation system in Hong Kong women. Asian J Surg 2005;28:18-23 
  14. Wang B, Jiang Y, Zhang MK, Li SY, Niu RL, Liu G, et al. Efficacy and safety of percutaneous ultrasound-guided vacuum-assisted excision for the treatment of clinical benign breast lesions larger than 3 cm: a retrospective cohort study. Ann Transl Med 2022;10:1345 
  15. Itri JN. Patient-centered radiology. Radiographics 2015;35:1835-1846 
  16. Chetlen AL, Kasales C, Mack J, Schetter S, Zhu J. Hematoma formation during breast core needle biopsy in women taking antithrombotic therapy. AJR Am J Roentgenol 2013;201:215-222 
  17. Schaefer FK, Order BM, Eckmann-Scholz C, Strauss A, Hilpert F, Kroj K, et al. Interventional bleeding, hematoma and scar-formation after vacuum-biopsy under stereotactic guidance: Mammotome®-system 11g/8g vs. ATEC®-system 12g/9g. Eur J Radiol 2012;81:e739-e745 
  18. Hahn M, Okamgba S, Scheler P, Freidel K, Hoffmann G, Kraemer B, et al. Vacuum-assisted breast biopsy: a comparison of 11-gauge and 8-gauge needles in benign breast disease. World J Surg Oncol 2008;6:51 
  19. Lin LLY, Gao Y, Lewin AA, Toth HK, Heller SL, Moy L. Overstated harms of breast cancer screening? A large outcomes analysis of complications associated with 9-gauge stereotactic vacuum-assisted breast biopsy. AJR Am J Roentgenol 2019;212:925-932 
  20. Longo JM, Bilbao JI, Barettino MD, Larrea JA, Pueyo J, Idoate F, et al. Percutaneous vascular and nonvascular puncture under US guidance: role of color Doppler imaging. Radiographics 1994;14:959-972 
  21. Bick U, Trimboli RM, Athanasiou A, Balleyguier C, Baltzer PAT, Bernathova M, et al. Image-guided breast biopsy and localisation: recommendations for information to women and referring physicians by the European Society of Breast Imaging. Insights Imaging 2020;11:12 
  22. Soo AE, Shelby RA, Miller LS, Balmadrid MH, Johnson KS, Wren AA, et al. Predictors of pain experienced by women during percutaneous imaging-guided breast biopsies. J Am Coll Radiol 2014;11:709-716 
  23. Pang E, Crystal P, Kulkarni S, Murphy K, Menezes RJ. An audit of pain experienced during image-guided breast biopsy procedures at an academic center. Can Assoc Radiol J 2016;67:250-253 
  24. Seely JM, Hill F, Peddle S, Lau J. An evaluation of patient experience during percutaneous breast biopsy. Eur Radiol 2017;27:4804-4811 
  25. Mosier A, Semerad D, Smith D, Rim A, Hammond B. Breast biopsies are minimally painful, exceed patient expectations, and do not represent a genuine lasting harm for most women. Breast J 2016;22:590-592 
  26. Loving VA, Johnston BS, Reddy DH, Welk LA, Lawther HA, Klein SC, et al. Antithrombotic therapy and hematoma risk during image-guided core-needle breast biopsy. Radiology 2023;306:79-86 
  27. Chang JM, Yoen H. Breast biopsy and hematoma associated with antithrombotic therapy. Radiology 2023;306:87-89