Our Summary

The research paper discusses a rare case of a 60-year-old woman who experienced a severe internal blood clot or hematoma, without any external bleeding, after undergoing a vacuum-assisted breast biopsy (VABB). VABB is a minimally invasive procedure that is generally safe and accurate, with a low risk of complications. The most common complication is a mild to moderate hematoma, which usually happens at a low rate and can be treated with simple actions like applying pressure and dressing the area.

However, in this case, the woman had a massive hematoma after the biopsy. She returned to the clinic after a cluster of suspicious areas were identified in her left breast. The samples tested were found to be negative. She had no prior medical history and was not on any medication. About 15-30 minutes after the biopsy, she reported feeling weak, experiencing pain, and nearly fainting. A physical examination revealed the massive internal clot. Her blood pressure was low, and she had a low hemoglobin level indicating severe blood loss.

The medical emergency team stabilized her condition and then used a procedure called endovascular embolization to control the bleeding in her breast. Despite this being a rare complication, the authors emphasise the importance of having a well-planned protocol to manage such situations promptly and effectively. They also highlight the potential risk of damage to blood vessels, using similar cases to support their argument and to provide insights into different clinical manifestations of this rare occurrence.

FAQs

  1. What is a vacuum-assisted breast biopsy (VABB) and what are its common complications?
  2. What were the symptoms the 60-year-old woman experienced after her breast biopsy that led to the discovery of the massive hematoma?
  3. How did the medical team manage the severe internal blood clot in the patient’s breast after the biopsy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about breast biopsy is to closely follow post-biopsy care instructions provided by the healthcare provider. This may include avoiding strenuous activities, applying ice to the biopsy site to reduce swelling, and monitoring for any signs of infection or excessive bleeding. It is important to communicate any unusual symptoms or concerns to the healthcare provider promptly.

Suitable For

Patients who may be recommended for a breast biopsy include those with suspicious or abnormal findings on a mammogram, ultrasound, or physical exam, as well as those with a family history of breast cancer, a personal history of breast cancer or other breast conditions, or genetic mutations that increase the risk of breast cancer. Additionally, patients with symptoms such as a lump in the breast, nipple discharge, breast pain, or changes in breast size or shape may also be recommended for a biopsy. It is important for healthcare providers to carefully evaluate each patient’s individual risk factors and symptoms to determine the appropriate course of action.

Timeline

In summary, the timeline of events for this patient before and after the breast biopsy would be as follows:

Before biopsy:

  • Patient presents with suspicious areas in left breast
  • Undergoes vacuum-assisted breast biopsy procedure
  • Reports feeling weak, pain, and near fainting 15-30 minutes post-biopsy
  • Physical examination reveals massive internal hematoma
  • Blood pressure is low, hemoglobin level indicates severe blood loss

After biopsy:

  • Patient stabilized by medical emergency team
  • Endovascular embolization procedure used to control bleeding in breast
  • Rare complication of massive hematoma post-biopsy addressed
  • Importance of having well-planned protocol for managing such situations emphasized by authors and potential risks highlighted.

What to Ask Your Doctor

Some questions a patient should ask their doctor about breast biopsy include:

  1. What are the potential risks and complications associated with a breast biopsy?
  2. How common is it to experience a hematoma after a breast biopsy?
  3. What symptoms should I watch for after the biopsy that may indicate a complication like a hematoma?
  4. What steps will be taken to monitor and manage any potential complications during and after the biopsy procedure?
  5. How quickly should I seek medical attention if I experience severe pain, weakness, or other concerning symptoms following the biopsy?
  6. Are there any factors that may increase my risk of experiencing a complication like a hematoma during a breast biopsy?
  7. What follow-up care will be provided to ensure my recovery and monitor for any ongoing issues related to the biopsy?
  8. Are there any alternative biopsy methods or procedures that may have a lower risk of complications in my case?
  9. Can you provide information about the success rate and accuracy of the biopsy procedure in detecting any abnormalities in the breast tissue?
  10. How will the biopsy results be communicated to me, and what further steps may be necessary based on the findings?

Reference

Authors: Pansa E, Guzzardi G, Santocono S, Carriero A. Journal: Tomography. 2023 Jun 24;9(4):1246-1253. doi: 10.3390/tomography9040099. PMID: 37489467