Can Vacuum-Assisted Breast Biopsy (VABB) Treat Breast Cancer?

Vacuum-assisted breast biopsy (VABB) is a relatively new technique used in the diagnosis and treatment of breast masses. Instead of surgically removing the entire mass as traditionally done, vacuum-assisted excision uses a large-gauge needle to cut (shave) the mass into multiple small tissue fragments (cores) and gradually remove them using negative pressure. This technique is usually performed under ultrasound guidance; however, mammography or MRI guidance may be used depending on the case. Compared with conventional surgery, this method has the advantages of less scarring, better cosmetic outcomes, and potentially less pain. However, NOT all breast masses are suitable for this technique, despite the recent extensive promotional claims about the procedure from various providers.

1. Can Vacuum-Assisted Breast Biopsy Treat Breast Cancer?

• Absolutely NOT. For breast cancer, this is only a method of tumor biopsy and does not replace standard surgery. Studies have shown that, in malignant tumors, residual cancer cells remain at the tumor site in 53%–70% of patients after complete vacuum-assisted excision when they subsequently undergo definitive surgery. Therefore, if the tumor is removed by vacuum assistance alone without surgery, the risk of recurrence is very high.
• In addition, standard surgery allows for more accurate assessment of tumor size, which helps determine the most effective adjuvant treatment.

2. Vacuum-Assisted Breast Biopsy in the Treatment of Lesions Suspicious for Malignancy

• In cases of lesions with a high probability of malignancy, such as atypical ductal hyperplasia and lobular hyperplasia, or tumors with a high risk of recurrence, such as phyllodes tumors (especially borderline or malignant phyllodes tumors), wide surgical excision is still required after vacuum-assisted excision to ensure that no malignant component or residual tumor tissue remains after VABB. Therefore, if a high-risk lesion has already been identified, complete or wide excision from the outset may be a more appropriate and cost-effective approach.
• On the other hand, cutting a tumor into multiple small fragments may make pathological interpretation more difficult for the pathologist compared with excising the tumor intact as a single specimen. Therefore, depending on the clinical presentation, available equipment, technique, and other factors, the physician will determine the most appropriate approach for each patient.

3. Vacuum-Assisted Breast Biopsy for the Treatment of Benign Breast Tumors

• Vacuum-assisted breast excision can replace conventional surgery for the removal of benign breast tumors, particularly fibroadenomas, when the tumor is not too large, typically with an average size of 2–3 cm. The advantages include better cosmetic outcomes, although the cost is generally higher.
• However, approximately 70% of breast lesions are benign. Therefore, not all breast lesions, particularly benign ones, require surgical intervention or vacuum-assisted excision. In many cases, periodic follow-up is sufficient, and the appropriate management should be determined by a specialist.

The information above is for reference purposes only and is not intended as medical advice. Please contact your doctor for detailed medical consultation.