Early experience of vacuum-assisted excision for breast lesions – the VAEBreast study

Introduction Vacuum-assisted excision (VAE) is a minimally invasive technique increasingly used for the management of breast lesions of benign (B2) or uncertain malignant potential (B3). While surgical excision has traditionally been the standard treatment, VAE offers a less invasive alternative. This study evaluates the clinical outcomes of ultrasonography-guided VAE for B2 and B3 breast lesions. Method A retrospective, single-centre cohort study including consecutive patients who underwent VAE at Sahlgrenska University Hospital sue to B2 or B3 lesions between October 2017 and February 2025. All patients had pre-procedural core needle biopsies followed by multidisciplinary team evaluation. VAE procedures were performed by a breast surgeon in collaboration with a breast radiologist. Radiological follow-up was conducted at 3 and 12 months. Result A total of 37 patients with a median lesion size was 12 mm (IQR: 8-16 mm). Four lesions were histopathologically upgraded, three to breast cancer, two of which required subsequent surgical excision, while one was deemed completely excised with VAE. Five re-VAEs were performed, one due to relapse of papilloma with atypia and four due to residual lesions identified during follow-up. Complications included four patients with bleeding and one infection, none necessitated surgery. Discussion Based on our findings, VAE is a potential alternative to surgery in the management of B2-B3 lesions and could probably be used more extensively.