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Anticoagulation and Bleeding Risk After Core Needle Biopsy

¹ All authors: The Elizabeth Wende Breast Clinic, 170 Sawgrass Dr., Rochester, NY 14620.

OBJECTIVE. The objective of our study was to compare the bleeding complication rates after core needle biopsy in patients receiving anticoagulation therapy and those who had not to assess the safety of performing core needle breast biopsy in anticoagulated patients.

MATERIALS AND METHODS. Core needle biopsy was performed at 1,144 sites in 1,055 women from August 2004 to May 2007. A retrospective study of these cases was performed. The patient group was composed of 200 women (220 biopsy sites) who were taking anticoagulant therapy daily (180 patients, aspirin; 16 patients, warfarin; and four patients, Excedrin), and the control group was composed of 855 women (924 biopsy sites) who were not receiving daily anticoagulant therapy. Any adverse reactions after core needle biopsy, including the presence and size of bruises or lumps (hematomas), were recorded.

RESULTS. There was a statistically significant difference (p = 0.035) in the percentage of bruises between patients receiving anticoagulation therapy and those who were not. Bruising occurred in 68 of the 200 (34%) women in the patient group (anticoagulated), whereas bruising occurred in 227 of the 855 (26.5%) women in the control group (nonanticoagulated). The differences were not statistically significant for hematoma formation (p = 0.274) or bruising with hematoma formation (p = 0.413). Hematoma occurred in 12 of the 200 (6%) anticoagulated patients versus 36 of the 855 (4.2%) patients in the control group. Patients reporting a bruise and lump (hematoma) numbered 10 of 200 (5%) for the anticoagulated group and 32 of 855 (3.7%) for the control group.

CONCLUSION. No patients undergoing core needle biopsy reported any clinically important complications. The results of this study confirm that performing core needle biopsy in patients on anticoagulation therapy is safe.

Keywords: breast biopsy • breast cancer • breast mass • mammography • MRI guidance • sonographic guidance • stereotactic guidance

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