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

Although VABB technology has become quite mature, next-generation products are evolving toward greater intelligence, customization, and multifunctionality to meet rising demands for early diagnosis, precise treatment, and patient comfort. This article outlines the technological advancements expected in VABB needles over the next five years.

1. Smart Sensing: Enabling Needles to "Perceive" Tissue Properties

Future VABB needles could integrate miniature impedance sensors or near-infrared spectroscopy probes at their tips. When the needle tip contacts different tissues (fat, glands, fibromas, cancerous lesions), characteristic differences in impedance spectra or absorption spectra will emerge, enabling real-time tissue identification through algorithms and guiding the operator to adjust sampling positions accordingly. Preliminary studies suggest this technology can increase the detection rate of malignant lesions by 12%, while reducing unnecessary sampling attempts.

II. Robotic Assistance: Synergy between Ultrasound and Robotic Arms

By integrating AI-based image recognition with robotic arms, automated VABB procedures can be achieved. The ultrasound probe automatically tracks the lesion, while the robotic arm guides the VABB needle along a pre-defined path for insertion, rotation, and tissue sampling. Doctors only need to confirm the target point on the console, after which the system completes the entire sampling process autonomously. This "one-button biopsy" mode significantly reduces procedure time (from 15 minutes to 5 minutes) and eliminates errors caused by hand tremors. A prototype has already entered clinical trials in 2025.

3. 3D-Printed Customized Needles

Each patient has unique breast size, lesion depth, and surrounding vascular distribution. Using preoperative MRI data, selective laser melting (SLM) technology can be employed to print VABB needles that perfectly match the patient's anatomy. The needle design can feature a gradient wall thickness: thicker at the proximal end for enhanced rigidity against bending, and thinner at the distal end for greater flexibility to conform to breast curvature. Materials such as Ti-6Al-4V or Co-Cr-Mo alloys may be used, offering superior biocompatibility. Although current costs are relatively high (approximately $300 per needle), with improvements in 3D printing efficiency, routine clinical application is expected by 2030.

Four: Multifunctional Integration-Diagnosis + Treatment + Imaging

The new-generation VABB needle will integrate more functions:

• Therapeutic function: After sampling, slow-release chemotherapy drugs or immunomodulators are injected through the same needle track, enabling "sample and treat" immediately;
• Fluorescence labeling: The needle tip carries indocyanine green (ICG), clearly delineating tumor margins under intraoperative fluorescence imaging to assist precise excision in breast-conserving surgery;
• Radiofrequency ablation: The needle integrates bipolar radiofrequency electrodes, allowing direct ablation of small malignant lesions (<1 cm) and avoiding secondary surgery.

5. Virtual Reality Training System

To shorten the learning curve for novice physicians, a VR-based VABB simulator has now entered commercial use. Trainees wear headsets and hold force-feedback handles to practice needle insertion angle, depth, and timing of vacuum activation within virtual ultrasound images. The system records deviations in puncture path, tissue loss volume, and procedure time, then provides performance scores. This immersive training reduces error rates during actual procedures by 40%.

Conclusion

From passive sampling to active sensing, from standardization to personalization, and from single diagnosis to integrated diagnosis and treatment, vacuum-assisted breast biopsy needles under ultrasound guidance are undergoing a silent revolution. These innovations will not only further improve the early detection rate of breast cancer but also redefine the boundaries of minimally invasive interventional therapy.