0:01

Like any biopsy performed, uh,

0:03

we worry about bleeding and infection.

0:06

I tell patients that they should expect

0:08

to have some bruising

0:09

because everybody bleeds at least a little bit.

0:13

Patients who are on blood thinners obviously would have

0:15

larger amounts of bleeding and bruising.

0:17

Uh, we do not cancel our procedures if patients are

0:22

on anticoagulation.

0:23

We just counsel them to know what to expect

0:27

and we hold pressure a little bit

0:28

longer after the procedure.

0:31

The likelihood of infection after a core biopsy is very low.

0:34

These are not sterile procedures,

0:36

however, we do clean the skin off

0:38

and everything we put inside the breast is sterile.

0:42

As long as you know what you can

0:44

and cannot touch, the likelihood

0:46

of contaminating a patient is very low.

0:49

And in my practice, I've known of maybe one

0:53

or two infections, um, that have come back to me.

0:56

Um, there may be others, but it is, I know uncommon.

1:01

There are additional, uh, problems with core biopsies,

1:04

not necessarily complications,

1:06

but things that require potential additional procedures

1:10

or at least, um, some type of problem solving.

1:13

Um, we'll talk a little bit more about discordant pathology

1:16

that might require a repeat biopsy or surgery.

1:20

This would not be known the day of the biopsy.

1:23

It would be known in a few days when the results

1:26

are available.

1:28

There's also the problem of inaccurate clip placement,

1:31

and this would be known the day of the biopsy

1:33

with the post biopsy mammogram, about 5% of cases, uh,

1:38

show a clip more than one centimeter from the target.

1:42

This mostly happens, um,

1:43

with mammographic guided procedures due

1:46

to the accordion effect.

1:48

So what does that mean? So here's an accordion here.

1:53

This is called the, these are called the bellows

1:55

of the accordion, and they are compressed in this image.

1:58

And notice the space

2:00

between these folds is very, very minimal.

2:03

But when the accordion is expanded,

2:06

these folds in the bellows are farther apart.

2:10

So distance when compressed is very little,

2:14

but may be magnified when the structure is expanded.

2:19

The same thing happens with, uh,

2:21

mammographic guided core biopsies and also with Mr.

2:24

'cause the breast is compressed

2:25

for both of those procedures.

2:27

So if the clip is placed when the breast is compressed

2:30

and maybe a few millimeters off,

2:33

when the breast is taking out of compression,

2:36

those few millimeters can be exaggerated

2:38

and sometimes the clip is even a few centimeters displaced

2:42

from the target site.