VAE replaces open surgery in benign and B3 lesions

 

Vacuum-assisted excision is a non-surgical procedure that can be used to remove benign lesions and biopsy/remove B3 lesions in the breast. It is widely used in UK, Netherlands, Spain, US, Canada, Poland, Russia among others since more than 10 years, but the Nordic countries have fallen behind.

 

The advantages of VAE compared to open surgery are many. ​

• No general anesthesia.

• No admission to hospital.

• Small incision with small scare.

• Shorter recovery time than open surgery.

• The hospital cost is reduced compared to open surgery.

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It is done under local anesthesia. The VAE needle is inserted into the breast and uses a combination of sucking and cutting to remove small amounts of breast tissue repeatedly until the lesion is gone. It does not require admission, general anesthesia or open surgery and is most often done with ultrasound guidance.

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A marker is left behind so a surgical resection can be done later if the removed material turns out to be malignant, despite previous benign biopsy.

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Small hematomas in the area are common while significant hematomas are rare since aspirating during the procedure and compressing afterwards.

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The UK NHS BSP assessment guidance document (publication 49) and the NHS BSP guidelines on the management of B3 lesions advocates replacing the standard surgical biopsy with VAE. This is an innovative and patient centered pathway to minimise overtreatment in this cohort of women.