Pseudoaneurysm in the Axillary Tail of the Breast After A Core Needle Biopsy

• Published in: European journal of breast health 2024-10, Vol.20 (4), p.313-315
• Main Authors: Pluguez-Turull, Cedric, Del Toro, Cinthia, Brofman, Nicole, Feliciano, Yara Z
• Format: Article
• Language: English
• Subjects: arterial phase hyperenhancement; Case Report; ct angiogram; pseudoaneurysm; thrombin; ultrasound-guided core needle biopsy; vascular mass; yin-yang sign
• ISSN: 2587-0831; 2587-0831
• 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.