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Randomized Controlled Trial
. 2025 May:186:112062.
doi: 10.1016/j.ejrad.2025.112062. Epub 2025 Mar 19.

Patient experience and healthcare cost aspects of vacuum-assisted excision of breast lesions. A report from the Swedish VAE randomized clinical trial

Athanasios Zouzos  1 , Irma Fredriksson  2 , Andreas Karakatsanis  3 , Theodoros Foukakis  4 , Fredrik Strand  5
Affiliations
Free article
Randomized Controlled Trial

Patient experience and healthcare cost aspects of vacuum-assisted excision of breast lesions. A report from the Swedish VAE randomized clinical trial

Athanasios Zouzos et al. Eur J Radiol. 2025 May.
Free article

Abstract

Background: Vacuum-assisted excision (VAE) of benign breast lesions is increasingly adopted owing to its clinical performance and convenience. However, the potential complications, impact on patient experience, and healthcare costs need to be thoroughly addressed, which is the focus of this study.

Materials and methods: The Swedish VAE trial was a prospective, single-blind, randomised trial. The patients were randomised to 7G or 10G needle size groups, and VAE was performed under ultrasound or mammographic guidance. Patient acceptance of the method and short-term complications were documented 7 and 15 days after the procedure. Long-term follow-up examinations were performed at 6 and 24 months after the procedure. The total procedural costs were calculated and compared with those of open surgical excision (OSE), the previous standard of care for surgical procedures.

Results: In the trial, VAE was performed on 208 patients, of whom 178 answered a questionnaire regarding their experience. Among those, 87 and 91 had their procedure performed with a 7G and 10G needle, respectively. There were no significant differences in pain levels (p = 0.713), complications (p = 0.724), or patient acceptance of the procedure between the two groups (p = 0.401). Fifty-five per cent (98/178) of all patients reported pain levels < 2 on a visual -analogue scale ranging from 1 to 10, while 12 per cent (21/178) reported pain levels > 6. Ninety-seven per cent (173/178) of the patients would recommend the procedure to others. The total hospital procedural cost of VAE was estimated to be 60 % lower than the cost of OSE (p < 0.001).

Conclusion: The VAE procedure using a 7G needle size was well -accepted by patients and conferred no increase in complications, including pain, compared to a 10G needle size. The VAE procedure had superior cost-efficiency compared to OSE.

Keywords: Health economics; Patient experience; Vacuum-assisted excision.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Athanasios Zouzos reports financial support was provided by Karolinska Institute. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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