Epinephrine-Containing Lidocaine and Hematoma Risk After Image-Guided Core-Needle Breast Biopsy

Area of Science:

• Radiology
• Interventional Radiology
• Oncology

Background:

• Core-needle breast biopsies (CNBBs) are common procedures.
• Hematoma formation is a potential complication of CNBBs.
• The role of epinephrine in lidocaine for reducing hematoma risk after CNBBs is not well-established.

Purpose of the Study:

• To compare the risk of symptomatic hematomas after CNBBs using epinephrine-containing lidocaine versus lidocaine alone.
• To evaluate the efficacy of epinephrine in reducing hematoma risk in image-guided CNBBs.

Main Methods:

• A retrospective review of CNBBs performed over a 12-month period.
• Patients received either lidocaine alone or epinephrine-containing lidocaine.
• Post-biopsy complications, including symptomatic hematomas, were assessed by nurse navigators.
• Mammograms were reviewed for hematomas, and logistic regression analyzed the data.

Main Results:

• A total of 1157 CNBBs were analyzed.
• No significant difference in hematoma risk was found for 12- to 14-gauge US-guided CNBBs.
• Epinephrine-containing lidocaine significantly reduced symptomatic (0.6% vs 4.1%) and mammographically evident hematomas (16.1% vs 41.2%) after 9-gauge CNBBs.

Conclusions:

• Epinephrine-containing lidocaine is effective in reducing hematoma rates following 9-gauge CNBBs.
• Consideration of epinephrine-containing lidocaine for 9-gauge CNBBs may enhance patient safety by lowering hematoma risk.