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

Early diagnosis of breast cancer is the key to improving the cure rate. Vacuum-assisted breast biopsy (VABB), as a minimally invasive sampling technique, has gradually replaced traditional open biopsy and has become the standard diagnostic method for imaging abnormalities. This article elaborates on the clinical value of VABB from four aspects: indications, operation procedures, diagnostic efficacy, and patient benefits.

1. The Indications Are Extensive

VABB is applicable in the following scenarios: ① Microcalcification clusters of BI-RADS 4 level or above detected by mammography; ② Irregular hypoechoic nodules visible by ultrasound; ③ Enhanced lesions shown by MRI; ④ Firmly palpable but undetermined nature of the mass; ⑤ Nipple discharge accompanied by ductal dilation. For early-stage lesions with a diameter less than 2 cm, VABB can obtain sufficient tissue for pathological examination, immunohistochemistry (ER/PR/HER2), and genetic testing, guiding subsequent chemotherapy or targeted therapy.

II. Operating Procedure: Precise, Fast, Minimally Invasive

The patient lies supine under local anesthesia, and the doctor locates the lesion under ultrasound or stereotactic guidance. A small incision of about 3 mm is made in the skin, and the VABB needle is inserted to the edge of the lesion. The vacuum pump is activated, and negative pressure sucks the tissue into the sampling slot. The rotating cutting sleeve cuts the tissue and transports it to the collection chamber. A single puncture can obtain 6–12 tissue cores, each with a diameter of approximately 2 mm and a length of 15–20 mm. The entire process takes about 15–20 minutes. After the procedure, only 5 minutes of pressure for hemostasis are required, and no suturing is necessary. Compared to traditional hollow needle biopsy (CNB), VABB yields a larger sample volume and has a lower degree of fragmentation, especially being suitable for the complete removal of microcalcifications.

III. Diagnostic Efficacy: High Sensitivity and Low False Negative Rate

Multiple large-scale clinical studies have shown that the sensitivity of VABB for diagnosing breast cancer is 97–99%, and the specificity is close to 100%. False negatives mainly result from small lesions (<5 mm) or special locations (close to the chest wall). For atypical hyperplasia (ADH) or lobular carcinoma in situ (LCIS), VABB can provide sufficient tissue for differential diagnosis, avoiding excessive surgery. Moreover, VABB can also be used for complete resection of benign lesions (such as fibroadenoma), achieving "diagnosis as treatment".

IV. Patient Benefits: Dual Reduction of Psychological and Physical Burdens

Compared with traditional open biopsy, the advantages of VABB are obvious: no scars, seamless healing, and quick recovery. Patients can resume normal activities immediately after the surgery, without affecting their work and life. More importantly, VABB reduces breast deformation and pain caused by biopsy, and lowers the anxiety level of patients. In the context of healthcare cost control, VABB also shortens the hospital stay (in some countries, it can be achieved as a day surgery), saving medical resources.

Conclusion

The advent of vacuum-assisted breast biopsy needles has ushered in the "precision minimally invasive era" in breast disease diagnosis. It not only enhances diagnostic accuracy but also improves the patient experience. As the design of the needle is continuously optimized (such as the introduction of finer 10G/12G specifications), the application scope of VABB will further expand, benefiting more women's health.