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Management of Patients with Breast Biopsy under Anti-Coagulation or Anti-Platelet Therapy: Results of a Survey of German Experts.
Riedel, Fabian; Hahn, Markus; Bader, Werner; Schäfgen, Benedikt; Fastner, Sarah; Hennigs, André; Gomez, Christina; Stieber, Anne; Fastner, Christian; Wallwiener, Markus; Golatta, Michael; Heil, Jörg; Fallenberg, Eva Maria.
Afiliación
  • Riedel F; Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany.
  • Hahn M; Department for Women's Health, Tübingen University Hospital, Tübingen, Germany.
  • Bader W; Department of Gynecology and Obstetrics, Bielefeld OWL University Hospital, Bielefeld, Germany.
  • Schäfgen B; Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany.
  • Fastner S; Heidelberg Breast Center at the St. Elisabeth Clinic, Heidelberg, Germany.
  • Hennigs A; Heidelberg Breast Center at the St. Elisabeth Clinic, Heidelberg, Germany.
  • Gomez C; Heidelberg Breast Center at the St. Elisabeth Clinic, Heidelberg, Germany.
  • Stieber A; Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany.
  • Fastner C; Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim (UMM), Medical Faculty Mannheim, Heidelberg University, European Center for AngioScience (ECAS), and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim,
  • Wallwiener M; Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany.
  • Golatta M; Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany.
  • Heil J; Heidelberg Breast Center at the St. Elisabeth Clinic, Heidelberg, Germany.
  • Fallenberg EM; Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany.
Breast Care (Basel) ; 19(2): 87-94, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38765898
ABSTRACT

Introduction:

Pre-therapeutic histologic diagnosis through image-guided core needle biopsy (CNB) or vacuum-assisted biopsy (VAB) for suspicious breast findings is a standard procedure. Despite the moderate risk of bleeding, a significant proportion of patients are on temporary or permanent anti-coagulation therapy (ACT) or anti-platelet therapy (APT). Currently, there are no established guidelines for managing biopsies in such patients, leading to varying approaches in clinical practice.

Methods:

An online survey was conducted among all members of the breast ultrasound working group at the German Society for Ultrasound in Medicine (DEGUM) and the working group for breast diagnostics at the German Radiology Society (DRG). It included n = 51 questions about individual risk perception of biopsy-related bleeding complications and the specific management of biopsies on ACT/APT.

Results:

A total of 332 experts participated, with 51.8% reporting the absence of a standardized management plan for breast biopsies on ACT/APT. Concerning specific ACT/APT medications, the survey revealed discrepancies in risk perception and management The majority preferred discontinuing medication with directly acting oral anti-coagulants (DOACs; CNB 66.9%; VAB 91.1%), phenprocoumon (CNB 74.9%; VAB 96.7%), or therapeutic heparin (CNB 46.1%; VAB 72.7%). However, there was a lower inclination to discontinue acetylsalicylic acid (ASA; CNB 15.2%; VAB 50.3%) or prophylactic heparin (CNB 11.9%, VAB 36.3%).

Conclusion:

Breast biopsies for patients on ASA or prophylactic heparin are deemed safe and part of standard clinical practice. However, despite available feasibility studies, conducting breast biopsies on ACT medications such as DOACs or phenprocoumon appears feasible only for a minority of experts.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Breast Care (Basel) Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Breast Care (Basel) Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Suiza