CNB relies on spring-driven cutting; specimens are prone to damage from shear and torsional forces during rapid advancement, resulting in fragmented, compressed and deformed tissue. Particularly for fat-rich breast tissue, CNB cores often twist into noodle-like strands, making normal ductal and lobular structures hard to distinguish under microscopy.

Vacuum suction in VABB draws tissue gently into the sample notch, followed by clean transection via a rotating cutting cannula, yielding well-layered cylindrical tissue cores. The cutting cannulas manufactured by Manners on Citizen L12-1M7 Swiss-type lathes feature an inner bore tolerance of ±0.01 mm, with electro-polished ultra-sharp cutting edges that drastically minimize tissue tearing.

Immunohistochemistry (IHC) staining requires a sufficient volume of tumor cells to accurately assess ER, PR and Ki-67 indices. A single CNB core typically contains only 200–500 tumor cells, which may produce false-negative results for low-cellularity tumors such as lobular carcinoma.

One VABB procedure harvests 10–20 tissue cores, delivering thousands to tens of thousands of total tumor cells and markedly boosting IHC positive detection rates. A meta-analysis covering 800 patients reported an ER/PR test failure rate of merely 0.8% for VABB, compared to 3.2% for CNB.

Intact RNA and DNA are prerequisites for successful Next-Generation Sequencing (NGS). Prolonged air exposure and repeated puncture in CNB trigger cellular apoptosis and substantial RNA degradation. VABB employs a sealed collection system that delivers specimens straight into fixative or RNA preservative fluid, while the vacuum environment lowers oxidative stress.

Furthermore, the 316L stainless steel used for VABB needles complies with RoHS and ISO 13485 standards, free of heavy metal ions that would otherwise catalyze nucleic acid breakdown. For patients tested for germline BRCA1/2 mutations or Tumor Mutational Burden (TMB), VABB specimens outperform CNB in both DNA yield and purity.

Microcalcifications serve as a critical biomarker for Ductal Carcinoma In Situ (DCIS). After CNB sampling, X-ray radiography is routinely needed to verify the presence of calcifications; repeat puncture is required if no calcifications are identified.

VABB enables en bloc excision of the entire suspicious lesion, with calcifications isolated from the resected tissue, achieving a retrieval rate exceeding 95%. This is vital for precise DCIS grading (nuclear grade, necrosis assessment) and surgical margin evaluation.