TY  - JOUR
A1  - Riedel, Fabian
A1  - Hahn, Markus
A1  - Bader, Werner
A1  - Schäfgen, Benedikt
A1  - Fastner, Sarah
A1  - Hennigs, André
A1  - Gomez, Christina
A1  - Stieber, Anne
A1  - Fastner, Christian
A1  - Wallwiener, Markus
A1  - Golatta, Michael
A1  - Heil, Jörg
A1  - Fallenberg, Eva Maria
UR  - https://doi.org/10.1159/000536079
CY  - Basel ; Freiburg, Br. ; Paris ; London ; New York, NY ; Bangalore ; Bangkok ; Shanghai ; Singapore ; Tokyo ; Sydney
SN  - 1661-3791 (Druck-Ausg.); 1661-3805 (Online-Ausg.)
IS  - 2
EP  - 95
Y1  - 2024///
ID  - heidok36578
JF  - Breast Care
AV  - public
SP  - 87
KW  - Breast
KW  -  Biopsy
KW  -  Anti-coagulation
KW  -  Anti-platelet therapy
KW  -  Expert survey
TI  - Management of Patients with Breast Biopsy under Anti-Coagulation or Anti-Platelet Therapy: Results of a Survey of German Experts
PB  - Karger
N1  - Dieser Beitrag ist aufgrund einer (DFG-geförderten) Allianz bzw. Nationallizenz frei zugänglich. *** This publication is freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.
VL  - 19
N2  - 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 <i>n</i> = 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.
ER  -