title: Hematoma formation during breast core needle biopsy in women taking antithrombotic therapy.
abstract: OBJECTIVE
  The purpose of this study was to compare hematoma formation after breast core needle biopsy performed on patients undergoing and those not undergoing concurrent antithrombotic therapy.
  
  
  METHODS
  A prospective assessment of core needle biopsies (stereotactic, ultrasound guided, or MRI guided) performed on patients enrolled between September 2011 and July 2012 formed the basis of this study. Postprocedure mediolateral and craniocaudal mammograms were evaluated for the presence and size of hematomas. Patients were clinically evaluated for complications 24-48 hours after the procedure through telephone call or face-to-face consultation. Needle size, type of biopsy, and presence of hematoma and documented complications were correlated with use of antithrombotic agents (including aspirin, warfarin, clopidogrel, and daily nonsteroidal antiinflammatory medications).
  
  
  RESULTS
  No clinically significant hematomas or bleeding complications were found. Eighty-nine of 617 (14.4%) non-clinically significant hematomas were detected on postprocedure mammograms. The probability of development of a non-clinically significant hematoma was 21.6% for patients taking antithrombotics and 13.0% for those not taking antithrombotics. Concurrent antithrombotic therapy and larger needle gauge were significant factors contributing to the probability of hematoma formation. The volume of the hematoma was not related to needle gauge or presence of antithrombotic therapy.
  
  
  CONCLUSIONS
  No clinically significant hematomas were found. Because there are potential life-threatening risks to stopping antithrombotic therapy before breast biopsy, withholding antithrombotic therapy for core needle breast biopsy is not recommended because the incidence of non-clinically significant hematoma is low.
authors.affiliation: Department of Radiology, Breast Imaging, Penn State Milton S. Hershey Medical Center, EC 008, 30 Hope Dr, Ste 1800, Hershey, PA 17033-0859, USA. achetlen@hmc.psu.edu
authors.forename: Alison L
authors.initials: AL
authors.lastname: Chetlen
authors.forename: Claudia
authors.initials: C
authors.lastname: Kasales
authors.forename: Julie
authors.initials: J
authors.lastname: Mack
authors.forename: Susann
authors.initials: S
authors.lastname: Schetter
authors.forename: Junjia
authors.initials: J
authors.lastname: Zhu
mesh_terms: D062005:Biopsy, Large-Core Needle / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006406:Hematoma / Q000000981:diagnostic imaging* / Q000209:etiology*; D006801:Humans; D016015:Logistic Models; D053783:Magnetic Resonance Imaging, Interventional; D008327:Mammography; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D013238:Stereotaxic Techniques; D018084:Ultrasonography, Interventional
chemical_list: D005343:Fibrinolytic Agents