Vacuum-assisted excision (VAE) of breast lesions of uncertain malignant potential (B3 lesions) as an alternative to surgical excision: an experience at the Versilia Hospital

This study aims to assess use and efficacy of vacuum-assisted excision (VAE) treating B3-lesions as an alternative to surgical excision and to analyse the malignant upgrade rate, the number and the type of post-VAE complications. 50 female patients have been evaluated at the Breast Unit at Versilia Hospital between May 2023 and November 2024 and they underwent VAE, after detecting suspicious lesions in mammography. No significant complications post-VAE have been observed in all patients. Other minor complications were: spontaneously resolved hematomas in 2 cases, dislocation of clips in 2 cases, significant bleeding in 1 case and fainting in 1 case. 19 out of 50 patients (38%) underwent surgical excision after breast multidisciplinary team meeting: 4 of them (8%) have upgraded to CDIS and CDI. Remaining 31 patients underwent negative first follow-up with mammography within 3-6 months after VAE. Conclusion: VAE can be considered safe and effective as an alternative surgical excision to the treatment of B3-lesions, sometimes avoiding over treatment and reducing costs and stress for patients.