Pluguez-Turull Cedric, Del Toro Cinthia, Brofman Nicole, Feliciano Yara Z
Department of Radiology, University of Miami Miller School of Medicine, Sylvester Cancer Center, and Jackson Memorial Hospital, Florida, USA.
University of Miami, Leonard M. Miller School of Medicine, Florida, USA.
Eur J Breast Health. 2024 Sep 26;20(4):313-315. doi: 10.4274/ejbh.galenos.2024.2024-4-5.
We present the case of a forty-year-old asymptomatic female with no personal or family history of breast cancer, who underwent a core needle biopsy (CNB) following the identification of a focal asymmetry in the right breast on screening mammography. Eight months later, a prominent adjacent vascular structure with a round outpouching was detected on breast ultrasound, confirmed as a post-biopsy pseudoaneurysm. Breast pseudoaneurysms, although exceedingly rare, result from inadvertent vessel puncture during core needle biopsies, particularly when larger gauge needles are used. They present as palpable, throbbing lumps in the breast and are well-defined heterogeneous structures that exhibit turbulent flow with a feeding artery on color Doppler imaging. This swirling sign showing a to-and-fro waveform is also known as the "yin-yang" sign on Doppler ultrasound. Post-CNB pseudoaneurysms in the breast, while rare, should be considered as potential complications following core need biopsy. Understanding their characteristic imaging features, risk factors, and available management options is essential for early diagnosis and appropriate treatment. This case underscores the importance of vigilance in biopsy procedures and the need for prompt recognition and intervention in case of such complications.
我们报告了一例40岁无症状女性的病例，该女性无乳腺癌个人史或家族史，在筛查乳腺X线摄影中发现右乳局灶性不对称后接受了粗针活检（CNB）。八个月后，在乳腺超声检查中发现一个突出的相邻血管结构，有一个圆形膨出，经证实为活检后假性动脉瘤。乳腺假性动脉瘤虽然极为罕见，但由粗针活检过程中意外穿刺血管所致，尤其是使用较大规格针头时。它们表现为乳腺内可触及的搏动性肿块，是边界清晰的异质性结构，在彩色多普勒成像中显示有供血动脉的湍流。这种显示来回波形的漩涡征在多普勒超声上也被称为“阴阳”征。乳腺活检后假性动脉瘤虽罕见，但应被视为粗针活检后的潜在并发症。了解其特征性影像学表现、危险因素及可用的治疗方案对于早期诊断和恰当治疗至关重要。该病例强调了活检操作中警惕性的重要性，以及出现此类并发症时及时识别和干预的必要性。
