| Outcomes | Test or Comparison | Overall Rating | Key Findings |
|---|---|---|---|
| Bleeding (any severity) | Alternative core needle biopsy methods | Low | – Median %: 1.21 (25th perc. = 0.33; 75th perc.= 3.97) – Selective outcome and analysis reporting likely – Few studies reported bleeding requiring treatment; the event rate was low (<0.40 perc.) in those studies |
| Bleeding events that require treatment | Alternative core needle biopsy methods | Low | – Median %: 0 (25th perc. = 0; 75th perc.= 0.14) – Selective outcome and analysis reporting likely – Few studies reported bleeding requiring treatment; the event rate was low |
| Hematoma formation | Alternative core needle biopsy methods | Low | – Median %: 1.44 (25th perc. = 0.25; 75th perc.= 8.57) – Selective outcome and analysis reporting likely |
| Infectious complications | Alternative core needle biopsy methods | Low | – Median %: 0 (25th perc. = 0; 75th perc.= 0.33) – Selective outcome and analysis reporting likely |
| Vasovagal reactions: | Alternative core needle biopsy methods | Low | – Median %: 1.27 (25th perc. = 0.37; 75th perc.= 3.88) – Potential for selective outcome and analysis reporting |
| Pain and severe pain | Alternative core needle biopsy methods | Low | 25 studies of a wide variety of biopsy methods reported information about patient pain during the procedure (pain was assessed heterogeneously across studies). |
| Other adverse events | Alternative core needle biopsy methods | Insufficient | – Most events were reported by a single study precluding assessment of consistency – Individual studies did not provide adequate information for precise estimation of the event rate) – Only informal indirect comparisons among biopsy methods were possible – Selective outcome and analysis reporting likely |
| Modifiers of adverse events – vasovagal reactions | Sitting upright during the biopsy procedure | Low | – Vasovagal reactions were more common among patients sitting during the biopsy procedure – Results were reported in few studies (11 studies; 8 from the original evidence report and 3 from this update) – Selective outcome and analysis reporting likely |
| Modifiers of adverse events – bleeding | Vacuum-assisted versus nonvacuum assisted biopsy methods | Low | – Vacuum-assisted procedures were generally associated with increased rates of bleeding and hematoma formation – Bleeding events were generally uncommon – Comparisons among biopsy methods were based on informal indirect comparisons (across studies) – Selective outcome and analysis reporting likely |
| All other modifiers of adverse events | Comparisons among alternative core needle biopsy methods | Insufficient | – Most factors assessed by a single study limiting our ability to assess consistency – Selective outcome and analysis reporting likely – Within-study comparisons provided direct evidence |
perc. = percentile.
From: Discussion
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