Pseudoaneurysm associated with arteriovenous fistula involving a superficial breast arteriole after vacuum-assisted removal of a benign mass: A case report

Microwave ablation of breast pseudoaneurysm

Breast pseudoaneurysm is a very rare complication. In this study, we report a patient with huge breast pseudoaneurysm after ultrasound-guided vacuum-assisted biopsy (UGVAB) of breast nodules. In treatment, we used microwave ablation to treat the pseudoaneurysm, and then used UGVAB again to eliminate the complicated hematoma. The patients obtained good therapeutic effect. From this case, we experience that, before the interventional operations for breast nodules, the systematic ultrasound examination should be performed. In the needle entering channel, the obvious blood vessels should be avoided to reduce the unnecessary vascular injury. When the pseudoaneurysm occurs, the patient’s condition, pseudoaneurysm situation and hematoma size should be comprehensively considered, combined with the multidisciplinary consultation, for selecting the best treatment strategy.

Vacuum-Assisted Excision, Scarless Solution for Fibroadenoma Breast—A Single-Center Experience

Background  Fibroadenoma is one of the most common benign breast lesions that is frequently surgically excised in breast practice.

Aim  The aim of this study was to determine the efficacy and safety of ultrasound-guided (USG) vacuum-assisted excision biopsy (VAEB) of fibroadenoma.

Settings and Design  A retrospective observational study.

Methods and Materials  A total of 113 patients with 163 fibroadenomas who underwent USG-guided VAEB under local anesthesia with 7G and 10G probes using an Encor Enspire equipment were included in the study. The patients were followed up after 1, 6, and 12 months. The fibroadenomas up to 4 cm were excised as per the U.S. Food and Drug Administration-approved guidelines of the American Society of Surgeons for percutaneous removal of benign breast lesions.

Results  The percentage of complete excision rate was 98.8% and the most frequent complication encountered was hematoma including immediate and delayed accounting for 3.06%. There were no recurrent lesions in our study.

Conclusion  USG-guided VAEB of benign breast lumps can be a safe and effective alternative to surgical excision and had better patient satisfaction in terms of efficacy and cosmesis.

True Aneurysm of the Breast After Vacuum-assisted Removal of Benign Masses: A Case Report

Rationale

The most common complications of vacuum-assisted removal (VAR) for benign breast masses are hematoma, infection, and occasionally pseudoaneurysms. To the best of our knowledge, this is the first report of a true aneurysm following VAR for breast fibroadenomas.

Case Presentation

A 50-year-old woman underwent VAR of bilateral benign breast masses under ultrasonic guidance. Routine breast ultrasound examination was performed 3 months later, and no discomfort was observed during follow-up.

Diagnoses and Interventions

Physical examination revealed a slightly palpable, arterial-like pulsation in the lateral part of the right breast. The two-dimensional ultrasound showed that there was a well-defined anechoic nodule in the right breast at the 9 o’clock position 3 cm from the nipple, measuring 6 mm × 4 mm. Color Doppler sonography demonstrated that it was a localized dilated intramammary arteriole within the colorful flow. Spectral Doppler illustrated a high-velocity turbulent arterial flow component inside. Based on these findings, the patient was diagnosed with an iatrogenic true aneurysm of the breast. Given her overall good condition, conservative treatment with regular imaging surveillance was adopted.

Outcomes

Up to now, the patient remains asymptomatic, and the size of the aneurysm has not changed.

Lessons

With the increasing use of interventional diagnosis and treatment techniques, iatrogenic vascular complications are likely to occur more frequently. Careful duplex ultrasound examination prior to or following the procedure is strongly recommended. In the absence of risk factors, we recommend a conservative approach to small, stable aneurysms.

Endovascular management of iatrogenic arteriovenous fistula of the breast

Arteriovenous fistula formation after ultrasound-guided core biopsy of a breast lesion occurs rarely. This is the first reported case of experience with endovascular coil embolization in the management of this rare complication.

Axillary pseudoaneurysm post core needle biopsy

Imaging-guided Core Needle Biopsy (CNB) is a procedure for tissue sampling in case of suspicious findings, such as breast masses and abnormal lymph nodes. It provides definitive diagnosis with a high accuracy rate and generally with no significant complications. To our knowledge, this is the first case report to document a pseudoaneurysm of the axilla after CNB. An illustrative case and a diagnostic and therapeutic literature review are presented.