https://pmc.ncbi.nlm.nih.gov/articles/PMC4115763/

Early diagnosis and treatment of breast cancer are crucial for reducing mortality rates, and tissue biopsy is the gold standard for diagnosis. The vacuum-assisted breast surgery biopsy needle (VABB needle) has become the preferred tool for diagnosing abnormal breast lesions due to its minimally invasive, precise, and efficient characteristics. This article discusses the clinical value of the VABB needle from aspects such as indications, operation procedures, diagnostic efficacy, and comparison with open biopsy.

1. The Indications are Extensive

The VABB specification is applicable to the following scenarios:

• Suspicious mass: BI-RADS category 4 or above nodules detected by ultrasound or mammography;
• Microcalcification clusters: Stereotactic biopsy can precisely sample the calcified areas;
• Multiple lesions: One puncture can obtain multiple samples, avoiding multiple needle insertions;
• Preoperative marking: Place marking clips at the edge of the tumor to provide navigation for breast-conserving surgery.

Common specifications include 10G, 12G, and 14G. Among them, the outer diameter of the 10G type is approximately 3.4 mm, and it can obtain a tissue core with a diameter of about 2 mm, which is sufficient to meet the requirements of immunohistochemistry and molecular testing.

II. Operating Procedure: Vacuum Assistance, Seamless Operation

Under ultrasound or mammography guidance, the doctor makes a 3-4 mm incision on the skin and inserts the VABB needle to the edge of the lesion. The vacuum system is activated to create negative pressure, drawing the tissue into the sampling slot. Then, the cutting sleeve moves forward rapidly, cutting and sealing the sample within the needle cavity. This process can be repeated to continuously collect 6-12 tissue samples, without the need to withdraw the needle. The entire procedure takes an average of 15-20 minutes and can be completed with local anesthesia, allowing the patient to go home after the procedure.

III. Diagnostic Efficacy and Safety Data

Large-scale clinical studies have shown that the sensitivity of VABB for diagnosing breast cancer is 97–99%, the specificity is close to 100%, and the false negative rate is less than 2% (mainly due to incomplete sampling of calcification foci). Compared with traditional core needle biopsy (CNB), VABB has a higher sample sufficiency rate (>95% vs 80–85%) and good tissue integrity, which is convenient for pathologists to assess the ratio of ductal carcinoma in situ (DCIS) to invasive cancer. The complication rate is extremely low: hematoma < 1%, infection < 0.5%, and pneumothorax is rare. For patients taking anticoagulant drugs, VABB is also safe because vacuum aspiration can quickly control minor bleeding.

IV. Comparative Advantages over Open Surgical Biopsy

Open surgical biopsy requires the entire lesion to be removed under general anesthesia, leaving a 2–3 cm scar. Postoperatively, suturing and recovery are necessary. VABB only leaves a grain-sized scar without functional impairment and causes less psychological trauma. More importantly, VABB can take samples from multiple points of the same lesion, avoiding the omission of malignant areas, while open biopsy often only takes representative slices. In terms of economy, the cost of VABB is approximately one-third of that of open biopsy, and it also saves hospitalization and recovery time.

Conclusion

The emergence of vacuum-assisted breast surgery biopsy needles has transformed breast biopsy from a "bold and radical" procedure to a "precise and minimally invasive" one. It not only enhances the diagnostic accuracy but also improves the patient experience, becoming an indispensable part of the modern breast disease diagnosis and treatment system.