The breast necrosis caused by oral anticoagulant therapy
Introduction. Described in 1943 for the first time, breast necrosis during anticoagulant therapy is only rarely encountered in clinical practice. The objective of the article is to describe a patient who underwent anticoagulant therapy and developed breast necrosis during it. Case outline. A 57-year...
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| Format: | Article |
| Language: | English |
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Serbian Medical Society
2020-01-01
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| Series: | Srpski Arhiv za Celokupno Lekarstvo |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0370-8179/2020/0370-81791900127G.pdf |
| _version_ | 1818598580495056896 |
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| author | Guzijan Aleksandar Gajanin Radoslav Babić Božana Gajanin Vesna Jovanić Bojan |
| author_facet | Guzijan Aleksandar Gajanin Radoslav Babić Božana Gajanin Vesna Jovanić Bojan |
| author_sort | Guzijan Aleksandar |
| collection | DOAJ |
| description | Introduction. Described in 1943 for the first time, breast necrosis during anticoagulant therapy is only rarely encountered in clinical practice. The objective of the article is to describe a patient who underwent anticoagulant therapy and developed breast necrosis during it. Case outline. A 57-year-old female patient was admitted to hospital with pain in her left breast, which upon examination showed to be erythematous, swelled, and hard. She had started experiencing the symptoms a few days earlier, and denied having had a fever. Over the previous four weeks she had received anticoagulant treatment (acenocoumarol) as popliteal embolectomy prophylaxis. The breast was firm, edematous, of limited mobility, and with no pectoral muscle infiltration. The breast ultrasound showed a homogeneous mass, with no signs of fluid retention or suspicious lesions. Upon admission, the patient began receiving intravenous antibiotic treatment and underwent blood tests. The second day upon admission, the patient’s breast revealed a clearly demarcated area of necrotic skin. Surgical treatment was indicated. The surgery was performed in two stages, the first of which included a partial resection of the necrotic breast tissue, and the second simplex mastectomy. Histological analysis showed severe superficial necrosis, with underlying diffuse deep venous thrombosis and marked arteritis of medium and small vessels. Focal areas of extensive necrosis were found deep in the breast parenchyma. Conclusion. Considering that breast necrosis is extremely rare, it is usually not suspected initially. Learning about the patient’s undergoing anticoagulant therapy is of crucial importance for reaching the right diagnosis. Breast abscesses should also be ruled out. Surgery is the treatment of choice, as changes to the breast tissue are usually irreversible. |
| first_indexed | 2024-12-16T12:05:58Z |
| format | Article |
| id | doaj.art-d832ea30086c4e93bab8a3a3630f39e6 |
| institution | Directory Open Access Journal |
| issn | 0370-8179 |
| language | English |
| last_indexed | 2024-12-16T12:05:58Z |
| publishDate | 2020-01-01 |
| publisher | Serbian Medical Society |
| record_format | Article |
| series | Srpski Arhiv za Celokupno Lekarstvo |
| spelling | doaj.art-d832ea30086c4e93bab8a3a3630f39e62022-12-21T22:32:19ZengSerbian Medical SocietySrpski Arhiv za Celokupno Lekarstvo0370-81792020-01-011485-637237510.2298/SARH180517127G0370-81791900127GThe breast necrosis caused by oral anticoagulant therapyGuzijan Aleksandar0Gajanin Radoslav1Babić Božana2Gajanin Vesna3Jovanić Bojan4University Clinical Center of the Republic of Srpska, Banja Luka, Republic of Srpska, Bosnia and HerzegovinaUniversity Clinical Center of the Republic of Srpska, Banja Luka, Republic of Srpska, Bosnia and Herzegovina + University of Banja Luka, Faculty of Medicine, Banja Luka, Republic of Srpska, Bosnia and HerzegovinaUniversity Clinical Center of the Republic of Srpska, Banja Luka, Republic of Srpska, Bosnia and HerzegovinaUniversity of Banja Luka, Faculty of Medicine, Banja Luka, Republic of Srpska, Bosnia and HerzegovinaUniversity Clinical Center of the Republic of Srpska, Banja Luka, Republic of Srpska, Bosnia and HerzegovinaIntroduction. Described in 1943 for the first time, breast necrosis during anticoagulant therapy is only rarely encountered in clinical practice. The objective of the article is to describe a patient who underwent anticoagulant therapy and developed breast necrosis during it. Case outline. A 57-year-old female patient was admitted to hospital with pain in her left breast, which upon examination showed to be erythematous, swelled, and hard. She had started experiencing the symptoms a few days earlier, and denied having had a fever. Over the previous four weeks she had received anticoagulant treatment (acenocoumarol) as popliteal embolectomy prophylaxis. The breast was firm, edematous, of limited mobility, and with no pectoral muscle infiltration. The breast ultrasound showed a homogeneous mass, with no signs of fluid retention or suspicious lesions. Upon admission, the patient began receiving intravenous antibiotic treatment and underwent blood tests. The second day upon admission, the patient’s breast revealed a clearly demarcated area of necrotic skin. Surgical treatment was indicated. The surgery was performed in two stages, the first of which included a partial resection of the necrotic breast tissue, and the second simplex mastectomy. Histological analysis showed severe superficial necrosis, with underlying diffuse deep venous thrombosis and marked arteritis of medium and small vessels. Focal areas of extensive necrosis were found deep in the breast parenchyma. Conclusion. Considering that breast necrosis is extremely rare, it is usually not suspected initially. Learning about the patient’s undergoing anticoagulant therapy is of crucial importance for reaching the right diagnosis. Breast abscesses should also be ruled out. Surgery is the treatment of choice, as changes to the breast tissue are usually irreversible.http://www.doiserbia.nb.rs/img/doi/0370-8179/2020/0370-81791900127G.pdfanticoagulantsnecrosisgangrenebreasthemorrhagic |
| spellingShingle | Guzijan Aleksandar Gajanin Radoslav Babić Božana Gajanin Vesna Jovanić Bojan The breast necrosis caused by oral anticoagulant therapy Srpski Arhiv za Celokupno Lekarstvo anticoagulants necrosis gangrene breast hemorrhagic |
| title | The breast necrosis caused by oral anticoagulant therapy |
| title_full | The breast necrosis caused by oral anticoagulant therapy |
| title_fullStr | The breast necrosis caused by oral anticoagulant therapy |
| title_full_unstemmed | The breast necrosis caused by oral anticoagulant therapy |
| title_short | The breast necrosis caused by oral anticoagulant therapy |
| title_sort | breast necrosis caused by oral anticoagulant therapy |
| topic | anticoagulants necrosis gangrene breast hemorrhagic |
| url | http://www.doiserbia.nb.rs/img/doi/0370-8179/2020/0370-81791900127G.pdf |
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