Management of patients with breast biopsy under anti-coagulation or anti-platelet therapy

• Verfasst von: Riedel, Fabian [VerfasserIn]
• Verfasst von: Hahn, Markus [VerfasserIn]
• Verfasst von: Bader, Werner [VerfasserIn]
• Verfasst von: Schäfgen, Benedikt [VerfasserIn]
• Verfasst von: Fastner, Sarah [VerfasserIn]
• Verfasst von: Hennigs, André [VerfasserIn]
• Verfasst von: Gomez, Christina [VerfasserIn]
• Verfasst von: Stieber, Anne [VerfasserIn]
• Verfasst von: Fastner, Christian [VerfasserIn]
• Verfasst von: Wallwiener, Markus [VerfasserIn]
• Verfasst von: Golatta, Michael [VerfasserIn]
• Verfasst von: Heil, Jörg [VerfasserIn]
• Verfasst von: Fallenberg, Eva Maria [VerfasserIn]
• Titel: Management of patients with breast biopsy under anti-coagulation or anti-platelet therapy
• Titelzusatz: results of a survey of German experts
• Verf.angabe: Fabian Riedel, Markus Hahn, Werner Bader, Benedikt Schäfgen, Sarah Fastner, André Hennigs, Christina Gomez, Anne Stieber, Christian Fastner, Markus Wallwiener, Michael Golatta, Jörg Heil, Eva Maria Fallenberg
• E-Jahr: 2024
• Jahr: April 2024
• Umfang: 8 S.
• Fussnoten: Online veröffentlicht: 10. Januar 2024 ; Gesehen am 03.02.2025
• Titel Quelle: Enthalten in: Breast care
• Ort Quelle: Basel : Karger, 2006
• Jahr Quelle: 2024
• Band/Heft Quelle: 19(2024), 2 vom: Apr., Seite 87-94
• ISSN Quelle: 1661-3805
• DOI: doi:10.1159/000536079
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1916164048

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.