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Review
. 2022 Nov 30;29(12):9357-9364.
doi: 10.3390/curroncol29120734.

Complete Surgical Excision Is Necessary following Vacuum-Assisted Biopsy for Breast Cancer

Jung Ho Park  1 , So Eun Ahn  1 , Sanghwa Kim  1 , Mi Jung Kwon  2 , Yong Joon Suh  1 , Doyil Kim  1
Affiliations
Review

Complete Surgical Excision Is Necessary following Vacuum-Assisted Biopsy for Breast Cancer

Jung Ho Park et al. Curr Oncol. .

Abstract

Vacuum-assisted breast biopsy (VABB) has been replacing excisional biopsy in the treatment of benign breast lesions. Complete surgical excision is still needed for the lesions occasionally diagnosed with breast cancer after VABB. We aimed to characterize residual tumors after VABB and define a subset of patients who do not need surgical excision after VABB. From a retrospective database, we identified patients diagnosed with breast cancer after VABB guided with ultrasonography. Patients who underwent stereotactic biopsies were excluded. We reviewed clinicopathologic data and radiologic findings of the sample. We identified 48 patients with 49 lesions. After surgical excision, the residual tumors were identified in 40 (81.6%) lesions, and there was no residual tumor in nine (18.3%) patients. Imaging studies could not accurately locate residual tumors after VABB. A small tumor size on a VABB specimen was associated with no residual tumor on final pathology. However, residual tumors were identified in four (40%) of 10 lesions with a pathologic tumor size less than 0.5 cm. In conclusion, complete surgical excision remains the primary option for most of the patients diagnosed with breast cancer after VABB. Imaging surveillance without surgery should be carefully applied for selected low-risk patients.

Keywords: breast neoplasms; interventional; surgery; ultrasonography.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Microscopic findings of the breast cancer identified on VABB. There were multiple foci of microinvasive carcinoma (H&E, ×30). Resection margin was deemed involved because of the fragmented specimen. There was no residual tumor after complete surgical excision.
Figure 2
Figure 2
Radiologic findings of a representative case. (A) The initial non-mass lesion was excised by VABB and diagnosed with DCIS. (B) Second-look ultrasonography did not reveal residual tumor. (C) MRI revealed residual non-mass lesion surrounding post-VABB cavity. (D) The post-VABB site was localized with metallic wire and excised widely. Final pathology was a 4.2 cm sized DCIS.
See this image and copyright information in PMC

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