ArticleEuropean radiology2021
Effectiveness of percutaneous vacuum-assisted excision (VAE) of breast lesions of uncertain malignant potential (B3 lesions) as an alternative to open surgical biopsy.
Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 19 citations in OpenAlex.
- Methodological Considerations on Tomosynthesis-Guided Vacuum-Assisted Excision for B3 Breast Lesions.European journal of breast health · 2026Article
- Budget Impact Analysis of Vacuum-Assisted Excision Versus Surgical Excision for the Assessment of Breast Lesions of Uncertain Malignant Potential in Italy.PharmacoEconomics - open · 2026Article
- Vacuum-Assisted Breast Biopsy and Post-Biopsy Scarring: Implications for Imaging Interpretation.Diagnostics (Basel, Switzerland) · 2026Article
- Is Surgical Excision Mandatory for Sclerosing Adenosis Diagnosed on Core Needle Biopsy? Multimodal Imaging Features and Upgrade Outcomes in a Symptomatic Cohort.Diagnostics (Basel, Switzerland) · 2026Article
- Comparative analysis of the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging kinetic heterogeneity and apparent diffusion coefficient for grading invasive breast cancer.Diagnostic and interventional radiology (Ankara, Turkey) · 2026Article
- Predicting postoperative malignancy upgrading in B1-B3 breast lesions: combined utility of conventional ultrasound and contrast-enhanced ultrasound features.Quantitative imaging in medicine and surgery · 2026Article
- Tomosynthesis-Guided Vacuum-Assisted Excision of B3 Breast Lesions: Reducing Overtreatment Without Compromising Safety.European journal of breast health · 2026Article
- Value of ultrasound-guided vacuum-assisted excision in the treatment of non-malignant breast nodules diagnosed as BI-RADS 4A or higher by ultrasound.Gland surgery · 2026Article
- Vacuum-Assisted Excision of B3 Lesions: A District General Hospital Experience.The Indian journal of radiology & imaging · 2025Article
- Atypical Ductal Hyperplasia and Lobular In Situ Neoplasm: High-Risk Lesions Challenging Breast Cancer Prevention.Cancers · 2024Article
- High-risk breast lesions: a combined intratumoral and peritumoral radiomics nomogram model to predict pathologic upgrade and reduce unnecessary surgical excision.Frontiers in oncology · 2024Article
- Evaluating the use of vacuum-assisted excisions in the management of B3 breast lesions.The British journal of radiology · 2023Article
- Breast Lesions of Uncertain Malignant Potential (B3) and the Risk of Breast Cancer Development: A Long-Term Follow-Up Study.Cancers · 2023Article
- Percutaneous vacuum-assisted excision (VAE) of breast lesions of uncertain malignant potential (B3 lesions): a preliminary single-centre Italian experience.La Radiologia medica · 2023Article
- The road to breast cancer screening with diffusion MRI.Frontiers in oncology · 2023Review
- Ultrasound-guided 8-Gauge vacuum-assisted excision for selected B3 breast lesions: a preliminary experience.La Radiologia medica · 2022Article
- Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTraditionally B3 breast lesions are treated surgically, but overtreatment is a concern, as the majority have a final benign diagnosis. A national screening program introduced vacuum-assisted excision (VAE) for managing B3 lesions in late 2016. This retrospective study aimed to assess the outcomes associated with this approach.
methodsAll B3 lesions diagnosed between 01/2017 and 12/2019 were identified at two centres. Information was obtained on the initial biopsy and final histology, and method of VAE image guidance, needle size and number of cores. Lesions were excluded if there was cancer elsewhere in the breast at the time of diagnosis; the lesion was not suitable for VAE due to position in the breast or had B3 pathology for which open biopsy was still required. The final decision to offer VAE was always made at a multidisciplinary meeting (MDM). Risk difference was used to test the significance at p ≤ .05.
resultsIn total, 258 B3 lesions were diagnosed, 105 (40.7%) met the inclusion criteria and underwent VAE. VAE was performed under X-ray (89/105) or ultrasound guidance (16/105), taking an average of 18.5 cores with the 10-G needle or 10.8 cores with the 7-G needle. Nine cases (8.6%) were upgraded to a malignant diagnosis following VAE. Malignancy was found in 15.5% (9/58) of B3 lesions with epithelial atypia, but in none without atypia (0/47) (p = .004). No new lesions or malignancy has occurred at the site of the VAE with an average mammographic follow-up of 2.2 years.
conclusionUpgrade to malignancy following VAE was uncommon (8.6%) and associated with atypia in the initial biopsy. VAE is an alternative approach to the management of B3 lesions, reducing open surgical procedures. KEY POINTS: • Upgrade to malignancy after a vacuum-assisted excision of a B3 breast lesion is uncommon with an 8.6% upgrade rate. • The risk of a malignant diagnosis after a vacuum-assisted excision was significantly higher for B3 lesions with atypia compared to those without (+15.5% difference, p = .004).
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