Type:
Educational Exhibit
Keywords:
Performed at one institution, Observational, Retrospective, Haemorrhage, Aneurysms, Complications, Biopsy, Ultrasound-Colour Doppler, Ultrasound, Interventional non-vascular, Breast
Authors:
O. ASLAN1, A. Oktay2, I. GUNHAN BILGEN2; 1İZMİR/TR, 2Izmir/TR
DOI:
10.26044/ecr2020/C-10248
Conclusion
Pseudoaneurysm arises with the accumulation of blood flowing in the tissue adjacent to the vessel which develops with a hole or tear in the artery wall (3). Pseudoaneurysm does not have a real wall and is confined to surrounding tissues and fibrous capsule(3).
Pseudoaneurysm of the breast is rare and its natural development is not known. It occurs iatrogenically after breast biopsies.
Patients with a higher risk of developing pseudoaneurysm; older women with a history of atherosclerosis and hypertension, and the increased risk is associated with the use of anticoagulant drugs such as warfarin, heparin, and aspirin(5).
Most pseudoaneurysms spontaneously thrombose and are not noticed by clinicians(3). Pseudoaneurysm is easily diagnosed by color Doppler US(6). Color Doppler US shows the turbulent flow associated with the adjacent vessel within the mass(3).
Most pseudoaneurysms are self-thrombosed without symptoms but in some cases they present with persistent nodularity and are detected on control US. Thrombosis may not be occur with pressure applied to the neck of the pseudoaneurysm, because the pseudoaneurysm neck may be very large, especially after the rupture of the vessel wall using a 14G core biopsy needle(3).
Treatment alternatives include percutaneous alcohol or thrombin injection and surgical treatment.
Since the treatment plan was surgical excision due to solid mass in both of our cases, pseudoaneurysms were also excised in the same operation.
In conclusion, core breast biopsy is frequently used because of the prevalence of BIRADS4 and BIRADS5 lesions.
A pseudoaneurysm, which is a rare complication after core needle breast biopsy, should always be kept in mind. In doubt, colour Doppler US should be performed.