A Case of Arteriovenous Fistula of the Breast as a Complication of Core Needle Biopsy

Abstract

A 35-year-old woman was found to have a left breast mass on ultrasonography at an annual medical checkup. A subsequent needle biopsy revealed fibroadenoma. The biopsy was conducted without complications including major bleeding, but on the next day, she noticed engorged superficial blood vessels and discomfort in her left breast. The previous doctor palpated thrill at the same area and then the patient had been followed up. Two years later, she was referred to our hospital due to exacerbation of the symptoms. Computed tomography scan showed multiple dilated vessels directly from the artery on the surface of the breast. Angiography revealed three or more inflowing arteries and two outflowing veins, and the patient was diagnosed with a left mammary arteriovenous fistula. According to the Schöbinger's classification, it was considered to be in the second stage (expansion stage). If it progressed, the treatment would be difficult by developing general complications such as bleeding and heart failure, therefore the embolization was performed. The shunt disappeared after the procedure. Two years have passed without recurrence. We report a case of intramammary arteriovenous fistula as a complication associated with needle biopsy of a breast tumor.