Our Summary

This research paper is about a medical case involving a 65-year-old woman who had a particular type of breast biopsy, called a Core Needle Biopsy (CNB), to check for any suspicious lumps. After three weeks, a scan showed a swollen blood vessel with a neighboring sac in her breast, which was identified as a pseudoaneurysm (a false aneurysm). This is a rare but severe complication from the biopsy procedure. The researchers found very few similar cases reported over the past 20 years. Although these pseudoaneurysms may clot on their own, they often need treatment, so it’s crucial for doctors to be aware of this risk when conducting this type of biopsy.

FAQs

  1. What is a Core Needle Biopsy (CNB) and why is it used?
  2. What is a pseudoaneurysm and how can it be a complication from a breast biopsy?
  3. What is the likelihood of developing a pseudoaneurysm after a breast biopsy, and how is it typically treated?

Doctor’s Tip

A helpful tip a doctor might tell a patient about breast biopsy is to closely monitor the biopsy site for any unusual symptoms such as excessive swelling, bruising, or pain. It’s important to report any of these symptoms to your doctor immediately, as they could be signs of a potential complication like a pseudoaneurysm. Early detection and treatment can prevent further complications and ensure the best possible outcome. Additionally, following post-biopsy care instructions, such as avoiding strenuous activities and taking prescribed medications, can help promote healing and reduce the risk of complications.

Suitable For

Patients who are typically recommended for a breast biopsy include those who have:

  1. Abnormal findings on a mammogram or ultrasound, such as a suspicious lump or mass
  2. Abnormal changes in the breast, such as nipple discharge, skin dimpling, or changes in breast shape or size
  3. A family history of breast cancer or a genetic mutation that increases the risk of developing breast cancer
  4. A personal history of breast cancer or other breast-related conditions
  5. A previous biopsy that showed benign (non-cancerous) findings but with ongoing concerns or changes in the breast tissue
  6. Symptoms such as breast pain, redness, or swelling that may indicate a potential issue in the breast tissue

It is important for healthcare providers to carefully assess each patient’s individual risk factors and medical history before recommending a breast biopsy. The decision to undergo a biopsy should be made in consultation with a healthcare provider who can provide guidance on the best course of action based on the patient’s specific circumstances.

Timeline

Before the breast biopsy:

  1. The patient notices a suspicious lump in her breast during a routine self-examination.
  2. The patient schedules an appointment with her doctor to discuss the lump.
  3. The doctor recommends a breast biopsy to further investigate the lump and determine if it is cancerous.
  4. The patient undergoes pre-operative tests and consultations to prepare for the biopsy procedure.
  5. The patient receives information about the biopsy procedure, including potential risks and complications.

After the breast biopsy:

  1. The patient undergoes the Core Needle Biopsy procedure to remove a sample of tissue from the lump in her breast.
  2. The patient experiences some discomfort and minor bruising at the biopsy site following the procedure.
  3. The patient waits for the results of the biopsy to determine if the lump is cancerous.
  4. Three weeks after the biopsy, a scan reveals a swollen blood vessel and neighboring sac in the patient’s breast, identified as a pseudoaneurysm.
  5. The patient is informed about the rare complication and the need for further treatment to address the pseudoaneurysm.
  6. The patient undergoes additional tests and consultations to determine the best course of action for treating the pseudoaneurysm.
  7. The patient receives treatment for the pseudoaneurysm, which may include medication or a minimally invasive procedure to repair the blood vessel.
  8. The patient continues to follow up with her doctor for monitoring and additional tests to ensure the pseudoaneurysm is successfully treated and does not recur.

What to Ask Your Doctor

  1. What are the risks associated with a Core Needle Biopsy (CNB) procedure?
  2. How common is the occurrence of pseudoaneurysms following a CNB?
  3. What symptoms should I look out for that may indicate a complication from the biopsy?
  4. How will the pseudoaneurysm be treated if it does not resolve on its own?
  5. Are there any preventative measures that can be taken to reduce the risk of developing a pseudoaneurysm after a CNB?
  6. What follow-up care will be necessary to monitor for any potential complications?
  7. Are there alternative biopsy methods that may carry a lower risk of complications?
  8. What is the success rate of treating pseudoaneurysms that develop after a CNB?
  9. How long is the recovery time expected to be if treatment is required for a pseudoaneurysm?
  10. Are there any long-term implications or risks associated with having had a pseudoaneurysm following a CNB?

Reference

Authors: Swain B, Castelhano R, Litton K, Chaudhry A. Journal: Ann R Coll Surg Engl. 2022 Jan;104(1):e21-e24. doi: 10.1308/rcsann.2021.0099. Epub 2021 Nov 3. PMID: 34730422