Division of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea.
Department of Pathology, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea.
Curr Oncol. 2022 Nov 30;29(12):9357-9364. doi: 10.3390/curroncol29120734.
Vacuum-assisted breast biopsy (VABB) has been replacing excisional biopsy in the treatment of benign breast lesions. Complete surgical excision is still needed for the lesions occasionally diagnosed with breast cancer after VABB. We aimed to characterize residual tumors after VABB and define a subset of patients who do not need surgical excision after VABB. From a retrospective database, we identified patients diagnosed with breast cancer after VABB guided with ultrasonography. Patients who underwent stereotactic biopsies were excluded. We reviewed clinicopathologic data and radiologic findings of the sample. We identified 48 patients with 49 lesions. After surgical excision, the residual tumors were identified in 40 (81.6%) lesions, and there was no residual tumor in nine (18.3%) patients. Imaging studies could not accurately locate residual tumors after VABB. A small tumor size on a VABB specimen was associated with no residual tumor on final pathology. However, residual tumors were identified in four (40%) of 10 lesions with a pathologic tumor size less than 0.5 cm. In conclusion, complete surgical excision remains the primary option for most of the patients diagnosed with breast cancer after VABB. Imaging surveillance without surgery should be carefully applied for selected low-risk patients.
真空辅助乳腺活检（VABB）已在良性乳腺病变的治疗中取代了切除术。在 VABB 后偶尔诊断出乳腺癌的病变仍需要完全手术切除。我们旨在描述 VABB 后的残留肿瘤，并确定一组 VABB 后无需手术切除的患者。我们从回顾性数据库中确定了在超声引导下接受 VABB 治疗后被诊断为乳腺癌的患者。排除了接受立体定向活检的患者。我们复习了样本的临床病理数据和影像学表现。我们共确定了 48 例 49 个病变患者。在接受手术切除后，40 个（81.6%）病变中发现了残留肿瘤，9 个（18.3%）患者没有残留肿瘤。影像学检查无法准确定位 VABB 后的残留肿瘤。VABB 标本中小的肿瘤大小与最终病理学上无残留肿瘤相关。然而，在病理肿瘤大小小于 0.5cm 的 10 个病变中有 4 个（40%）存在残留肿瘤。总之，对于大多数在 VABB 后被诊断为乳腺癌的患者，完全手术切除仍然是主要选择。对于选定的低风险患者，应仔细应用无手术的影像学监测。
