Management of patients taking antiplatelet or anticoagulant medication requiring invasive breast procedures: United Kingdom survey of radiologists' and surgeons' current practice

Pritchard, M.G.; Townend, J.N.; Lester, W.A.; England, D.W.; Kearins, O.; Bradley, S.A.

doi:10.1016/j.crad.2007.09.006

« Previous Next »Clinical Radiology
Volume 63, Issue 3 , Pages 305-311, March 2008

Management of patients taking antiplatelet or anticoagulant medication requiring invasive breast procedures: United Kingdom survey of radiologists' and surgeons' current practice

M.G. Pritchard
- West Midlands Breast Screening Quality Assurance Reference Centre, West Midlands Cancer Intelligence Unit, University of Birmingham, Edgbaston, Birmingham, UK
J.N. Townend
- University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK
W.A. Lester
- University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK
D.W. England
- South Birmingham Breast Screening Programme, Breast Assessment Unit, University Hospital Birmingham NHS Foundation Trust, Birmingham Women's Hospital, Edgbaston, Birmingham, UK
O. Kearins
- West Midlands Breast Screening Quality Assurance Reference Centre, West Midlands Cancer Intelligence Unit, University of Birmingham, Edgbaston, Birmingham, UK
S.A. Bradley
- South Birmingham Breast Screening Programme, Breast Assessment Unit, University Hospital Birmingham NHS Foundation Trust, Birmingham Women's Hospital, Edgbaston, Birmingham, UK
- Guarantor and correspondent: S.A. Bradley, South Birmingham Breast Screening Programme, Breast Assessment Unit, University Hospital Birmingham NHS Foundation Trust, Birmingham Women's Hospital, Edgbaston, Birmingham B15 2TG, UK. Tel.: +44 121 623 6890; fax: +44 121 623 6891.

Received 21 June 2007; accepted 14 September 2007.

Aim

To determine the current practice in the UK National Health Service Breast Screening Programme for invasive diagnostic procedures and surgery in patients taking anticoagulant and antiplatelet medication.

Materials and methods

Lead radiologists and surgeons at each breast screening service were surveyed to determine current practice. One hundred and five respondents provided information regarding their services, protocols, and willingness to proceed with combinations of procedures and anti-haemostatic medications.

Results

Between units there was wide variation in practice. Within 21 services providing more than one response, 10 (48%) disagreed on whether protocols existed. Decisions to perform biopsies were unrelated to professional group. The taking of a drug history was variable. Surgeons reported more adverse effects than radiologists [21 (48%) versus 12 (26%)], but no difference in self-assessment of knowledge.

Conclusion

Both radiologists and surgeons have expressed uncertainty about their understanding of anticoagulant and antiplatelet treatment. This is reflected in a wide range of practice. Guidance regarding the management of these patients is suggested.