Breast necrosis induced by the use of coumadin: case report and review of literature

Ejzenberg, Dani; Neusquen, Lucienne P.ereira Del G.rossi; Rolnik, Daniel L.; Lozinsky, Adriana Chebar; Piato, José Roberto Morales

doi:10.1590/s1679-45082015rc2829

Cited by 6 publications

(9 citation statements)

References 7 publications

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“…On average, the risk of breast necrosis among patients receiving anticoagulant therapy ranges 0.01-0.1% [2]. As for the cases of breast necrosis, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…In 35% of all the cases described, necrosis was multifocal. According to the existing literature, 15% of all the cases of necrosis associated with the administration of anticoagulant therapy concerned breast tissue [2,3]. In 1952, Verhagen wrote about soft tissue necrosis resulting from the administration of anticoagulant therapy, reporting on 13 cases, in one of which breast tissue was affected [4].…”

Section: Introductionmentioning

confidence: 99%

“…Breast necrosis is progressive and leads to dry breast gangrene. The etiology of breast necrosis remains unclear [1,2,5]. The sporadic nature of the condition cannot supply enough data on the this rare phenomenon [6].…”

Section: Introductionmentioning

confidence: 99%

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The breast necrosis caused by oral anticoagulant therapy

et al. 2020

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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.

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“…On average, the risk of breast necrosis among patients receiving anticoagulant therapy ranges 0.01-0.1% [2]. As for the cases of breast necrosis, i.e.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The breast necrosis caused by oral anticoagulant therapy

et al. 2020

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“…The warfarin-induced skin necrosis usually occurs in areas of excessive subcutaneous cellular tissue, most frequently affecting breasts (10 to 15%) [19][20][21][22] , buttocks, and thighs 23,24 . It typically occurs in obese middle-aged women, using warfarin due to deep venous thrombosis and/or pulmonary thromboembolism, and it is rare among coumarin users due to cerebrovascular insufficiency and atrial fibrilation 11 .…”

Section: Discussionmentioning

confidence: 99%

“…The use of new oral anticoagulants with different action mechanism, such as direct thrombin inhibitors of the Xa factor, is also advocated 30 . Currently, despite proper treatment, more than half of the patients will require surgical debridement, amputation or total mastectomy [19][20][21][22]24,26,29 .…”

Section: Discussionmentioning

confidence: 99%

Breast necrosis in a chronic user of warfarin

Cassol¹,

Morales²,

M³

et al. 2017

Mastology

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A necrose cutânea induzida por varfarina é um evento raro, que geralmente ocorre nos primeiros dias de uso dessa medicação, sendo atribuída ao provável efeito inicial pró-trombótico causado pelo desbalanço transitório entre fatores pró e anticoagulantes. É descrito o primeiro caso de necrose mamária em uma mulher de 50 anos usuária crônica de varfarina, a qual teve seu efeito anticoagulante potencializado pelo uso concomitante de diclofenaco sódico.

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Warfarin

2016

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Breast necrosis induced by the use of coumadin: case report and review of literature

Abstract: The coumadin-induced skin necrosis is rare and occurs more frequently in the breasts, thighs and buttocks. We describe the first case of coumadin necrosis of the breast in Brazil in a 62-year-old patient.

Cited by 6 publications

References 7 publications

The breast necrosis caused by oral anticoagulant therapy

The breast necrosis caused by oral anticoagulant therapy

Breast necrosis in a chronic user of warfarin

Warfarin

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