Sonographically Guided Vacuum-Assisted Breast Biopsy for Complete Excision of Presumed Benign Breast Lesions

OBJECTIVES: Benign breast disease has a high prevalence and a substantial impact on women's quality of life. Excisional biopsy is still frequently used for the diagnosis of breast masses in China. We report our experience with percutaneous removal of presumed benign lesions under sonographic guidance with a multidirectional handheld vacuum-assisted biopsy device and evaluate this procedure as an alternative approach in the diagnosis and treatment of clinically benign breast lesions. METHODS: A total of 1766 sonographically guided vacuum-assisted excision procedures were performed on 738 patients with clinically benign breast lesions between February 2008 and October 2011. RESULTS: The mean patient age ± SD was 35.86 ± 11.2 years. The mean diameter of the lesions was 1.25 ± 0.70 cm. The mean number of cores needed to achieve removal was 11.6 ± 4.8. Fifty-nine percent of cases (436 of 738) had multiple breast lesions. There were no serious adverse events. There were only 37 cases with substantial bleeding. No cases had wound infection. Hematoma occurred in 62 cases (8%), but none needed surgical intervention. Skin damage occurred in only 5 cases (0.7%) and 14 cases (1.9%) had a vasovagal response. Most of the specimens (1755 of 1766 [99.4%]) were benign. Postoperative pain was minimal, and better cosmetic results were obtained than with conventional open biopsy. CONCLUSIONS: Percutaneous excisional biopsy with a sonographically guided vacuum-assisted core device is a safe and effective approach for accurate diagnosis and complete removal of presumed benign breast masses.