Reconsidering the therapeutic use for vacuum-assisted breast biopsy in breast cancer patients: a retrospective single-center study

Background: The management of breast cancer has evolved over the last few decades, with needle biopsy interventions now including vacuum-assisted breast biopsy (VABB). Previous studies have examined the utility of VABB for diagnosing breast diseases, although it remains unclear whether VABB is safe and effective for breast cancer. This study evaluated the residual tumor rate and prognosis of breast cancer patients who underwent VABB-based resection. Methods: This single-center retrospective study evaluated data of 89 Chinese female patients who underwent VABB between January 2011 and December 2018 and had confirmed malignancy on pathological diagnosis. All patients had complete clinical, treatment, and follow-up records. Outcomes were compared according to whether there was residual tumor after the VABB, as well as the time from the VABB to the surgery. Results: Residual tumor was detected for 62 of the 89 patients (69.6%). When we compared the residual and non-residual groups, we detected significant differences in the ultrasonography-determined diameter (P=0.002) and morphology (P=0.000) of tumor bed after VABB. T classification was also significantly different in the residual and non-residual groups (P=0.001). However, no significant differences were observed when we compared the resected and residual tumors histopathologically (all P>0.05). We did not detect significant differences in disease-free survival (DFS) when we compared the residual and non-residual groups over a median follow-up time of 52.3 months. However, in the residual group, a longer time to surgery after VABB (>31 days) was associated with significantly shorter DFS. Conclusions: While previous studies have indicated that VABB can be used for early breast cancer, we observed a residual tumor rate of 69.6%, which is consistent with previously reported results. If there is a strong suspicion of breast cancer based on the preoperative examination, the surgeon must be careful to reduce the risk of residual tumor whenever possible, and should also consider performing standard surgery after VABB.