The Evolving Role of Vacuum Assisted Biopsy of the Breast: A Progression from Fine‐Needle Aspiration Biopsy

Abstract

Background The management of breast disease has been greatly facilitated by the technology of needle biopsy interventions, and over the past 30 years, this has evolved from the use of fine-needle aspiration biopsy (FNAB) to the current methodology of vacuum assisted biopsy (VAB). Methods This article provides an historical review of the application of needle interventions of the breast in the diagnosis and management of breast conditions, and discusses current indications for the use of vacuum assisted biopsies and vacuum assisted excisions. Results Whilst FNAB continues to have a limited role in breast disease diagnosis, the necessity of achieving an histological diagnosis has preferentially seen the development and wider application of automated core needle biopsies (CNB) and VAB in the assessment and management of breast lesions. The advantages of CNB and VAB include the ability to distinguish in situ and invasive disease pre-operatively, and the ability to achieve prior knowledge of immunohistochemical tumour markers particularly in the setting of neoadjuvant drug treatments. Conclusion Due to its ability to obtain larger tissue samples, VAB does have diagnostic advantages over CNB and indications for the utilization of VAB are discussed. VAB additionally has an expanding role as a tool for breast lesion excision.

Metastatic Squamous Cell Carcinoma to the Cervical Lymph Nodes From an Unknown Primary Cancer: Management in the HPV Era

“…An argument in favor of core biopsy prior to endoscopy, particularly if the FNA cytology is completely non-diagnostic, is to detect diagnoses other than squamous cell carcinoma prior to going to the operating room, to avoid the rare, inadvertent misdiagnosis at frozen section leading to misguided treatment (56,59).…”

Accuracy of ultrasound-guided core-needle biopsy confronted with pathological findings and comparison of its costs with vacuum-assisted biopsy’s costs

“…Breast cancer (BC) incidence is rising in low-income and middleincome countries due to improvement in life expectancy, urbanization, and adoption of Western lifestyles 1,2 . In the context of breast screening programs, detection of small and non-palpable lesions is increasing 3 . Suspicious lesions require histopathological evaluation and percutaneous breast biopsy has become an alternative to open surgical biopsy in these cases 3 .…”

“…In the context of breast screening programs, detection of small and non-palpable lesions is increasing 3 . Suspicious lesions require histopathological evaluation and percutaneous breast biopsy has become an alternative to open surgical biopsy in these cases 3 . The main types of percutaneous breast biopsy are core-needle biopsy (CNB) 3 and vacuum assisted biopsy (VAB) 4 .…”

“…Suspicious lesions require histopathological evaluation and percutaneous breast biopsy has become an alternative to open surgical biopsy in these cases 3 . The main types of percutaneous breast biopsy are core-needle biopsy (CNB) 3 and vacuum assisted biopsy (VAB) 4 . CNB is less invasive and related to less bleeding and less pain, since it uses a thinner needle.…”

“…CNB is less invasive and related to less bleeding and less pain, since it uses a thinner needle. VAB allows larger tissue samples through a single skin puncture without need to repeatedly relocate the needle when a tethered device is used 3,4 .…”