Efficacy and Safety of Vacuum-Assisted Excision for Benign Breast Mass Lesion: A Meta-Analysis

Abstract

Background and Objective: Breast mass lesions are common; however, determining the malignant potential of the lesion can be ambiguous. Recently, to evaluate breast mass lesions, vacuum-assisted excision (VAE) biopsy has been widely used for both diagnostic and therapeutic purposes. This study aimed to investigate the therapeutic role of VAE. Materials and Methods: Relevant articles were obtained by searching PubMed and EMBASE on 3 September 2021. Meta-analyses were performed using odds ratios and proportions. To assess heterogeneity, we conducted a subgroup analysis and meta-regression tests. Results: Finally, 26 studies comprising 18,170 patients were included. All of these were observational studies. The meta-analysis showed that the complete resection rate of VAE was 0.930. In the meta-regression test, there was no significant difference. The meta-analysis showed a recurrence rate of 0.039 in the VAE group. The meta-regression test showed no statistical significance. Postoperative hematoma, pain, and ecchymosis after VAE were 0.092, 0.082, and 0.075, respectively. Conclusion: VAE for benign breast lesions showed favorable outcomes with respect to complete resection and complications. This meta-analysis suggested that VAE for low-risk benign breast lesions is a reasonable option for both diagnostic and therapeutic purposes.

Unexpected breast cancer mimicking benign lesions on ultrasound-guided vacuum-assisted excision biopsy: A retrospective cross-sectional study over a 20-year period

“…The efficiency and safety of US-VAEB for benign breast lesions are considered to be favorable. A meta-analysis ( 12 ) of 26 studies involving 18 170 cases showed that the pooled complete resection rate of US-VAEB was 0.930, the recurrence rate was 0.039, and postoperative hematoma, pain and ecchymosis rates after US-VAEB were 0.092, 0.082, and 0.075, respectively. These results indicate that US-VAEB is a reasonable option for low-risk benign lesions for both diagnostic and therapeutic purposes.…”

Minimally invasive treatment of early, good prognosis breast cancer—is this feasible?

“…Complication rates following VAE of post-procedure haematoma, pain, and ecchymosis were reported as being 92% (95% CI, 0.07-0.13), 82% (95% CI, 0.05-0.13) and 75% (95% CI, 0.05-0.12) respectively, significantly higher than those for open surgical approaches. 20 Lower rates of haematoma were reported in a further meta-analysis which suggested rates of around 2.6%-3.3% following open surgery. However, it is unclear whether the nature and severity of the complications reported in the series of the two techniques are comparable—as surgical series often only report complications requiring operative evacuation whereas the majority of haematomas following VAE are treated conservatively.…”

Vacuum-assisted excision of breast lesions in surgical de-escalation: where are we?

“…In addition, the postprocedure aesthetics and the prolonged recovery time after open surgery result in lower patient satisfaction ( 15 ) . The main clinical indications for VAE are low adherence to follow-up, patient anxiety, increase in lesion volume during follow-up, symptoms, and planning to start hormone replacement therapy for assisted reproduction ( 16 , 17 ) .…”