An Extensive Breast Hematoma Following Stereotactic 9 Gauge Vacuum Assisted Large-Core Biopsy

An Extensive Breast Hematoma Following Stereotactic 9 Gauge Vacuum Assisted Large-Core Biopsy
Lee Pheng Yap, Hannah Rouse, Jennifer Cawson
The Breast 2010 16;2:199-200

Link to Journal

Vacuum assisted large-core biopsy is a widely used procedure for performing biopsy of suspicious breast lesions. However, it seems intuitive that the larger incised area of tissue with larger gauge biopsy devices increases hematoma risk. Whereas better tissue samples are obtained, the risk of bleeding is likely to be increased. Our patient had been on warfarin, although blood tests were in normal range before and after the procedure, and she was elderly and obese which are risk factors for wound hematomas.

Large core devices are unnecessary when smaller gauge needle core biopsy can achieve the diagnosis, at lower cost and morbidity. This case was amenable to 14G core biopsy, which is highly sensitive in most cases, and complications may have been avoided. The lesion type and patient risk factors should be considered and the biopsy procedure tailored to the individual case.