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Had Stereotactic Breast Biopsy. Hematoma Seen In The Area Of Biopsy. Related To Biopsy?

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Posted on Wed, 27 Feb 2013
Question: Due to some small calcifications
seen on a mammogram, 6mths ago I had a stereotactic breast biopsy, right upper outer quadrant. No malignancy. By the way, these calcifications had been seen on mammos for several years. The new study was done at a high risk breast screening clinic. I had modified upper mantle radiation treatment for Hodgkins disease 30 years ago. The upper, outer quadrant was not included in the field of the radiation therapy. Breast has been a bit tender ever since.Today had 6mth follow up mag view mammogram, very painful, followed by a breast ultrasound. The ultrasound showed what they think is a hematoma in the area of the biopsy. Today's mammogram showed no changes. Could the mag view mammogram have caused the hematoma??
doctor
Answered by Dr. Ganesh Sanap (44 minutes later)
Hi XXXXXXX welcome and thanks for writing in.
I would like to know certain things before diagnosis
1. is there mention the nature of haematoma like acute or chronic?
2. Why there is specific focus on upper outer quadrant now? Only for calcification or any other concern.
3. Are you feeling any lump in that area after biopsy.
Please let me know the above answer . It will be helpful for a precise conclusion.

Looking forward for your response.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ganesh Sanap (1 hour later)
Thank you
1.today there was no mention of acute or chronic. I should have asked. Said likely due to the biopsy of July 2012, sometimes takes a long time to heal. There was severe bruising and swelling at the time of the procedure. (maybe that is usual) The area remains a bit tender. I wondered if today's mammo had cause an "acute" hematoma. There was about 60mins between the mammo and the ultrasound. Unfortunately no pre-biopsy ultrasound for comparison. 6mth follow-up recommended again.
2.follow-up to July 2012. At that time the biopsy was recommended due to a pattern of calcifications seen on the mammo in that area only. The radiologist indicated the calcifications were most likely benign. There was an atypical ductal hyperplasia which the pathologist described as unlikely associated with, or a precursor to DCIS or invasive disease and that this was of uncertain significance. 6mth follow-up recommended
3. The area was vaguely lumpy before and after. I have history of insignificant fibrocystic breast condition for 30+ years. If anything I felt a "divot" in the area of the biopsy, tender at times.
It sure feels lumpy and sore now 12hours after today's mag view mammo
I was not able to complete any breast MRI..though was recommended, as was lumpectomy.
doctor
Answered by Dr. Ganesh Sanap (14 hours later)
Hi, welcome back.
From opinion of radiologist and pathological reports it doesn't look like a malignancy. Mammography technique itself is less likely to cause such haematoma . The procedure is predermined in such way that it will not cause trauma to tissue, though it is painful.
There is chance that there is small chronic haematoma due to previous biopsy which increased in size in present scan.
Lump is difficult to differentiate from fibrocystic lesions of breast.
At present I will suggest do regular follow up as advised by your physician. If there is signs of infection like fever or redness of breast then then consult on emergency basis. If is quite large and infected then drainage of haematoma may need in future.

Hope I have answered your query. If you have any further concern, please let me know.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Ganesh Sanap

Radiologist

Practicing since :2007

Answered : 566 Questions

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Had Stereotactic Breast Biopsy. Hematoma Seen In The Area Of Biopsy. Related To Biopsy?

Hi XXXXXXX welcome and thanks for writing in.
I would like to know certain things before diagnosis
1. is there mention the nature of haematoma like acute or chronic?
2. Why there is specific focus on upper outer quadrant now? Only for calcification or any other concern.
3. Are you feeling any lump in that area after biopsy.
Please let me know the above answer . It will be helpful for a precise conclusion.

Looking forward for your response.

Regards.