Funda Dinç Elibol1, Yelda Dere2, Ahmet Korkut Belli3, Cenk Elibol1, Özcan Dere3, Okay Nazlı3

1Department of Radiology, Mugla Sitki Kocman University School of Medicine, Mugla, Turkey
2Department of Pathology, Mugla Sitki Kocman University School of Medicine, Pathology, Mugla, Turkey
3Department of General Surgery, Mugla Sitki Kocman University School of Medicine, Mugla, Turkey


Objective: This study aimed to evaluate outcomes, complications, and follow-up results of ultrasound-guided vacuum-assisted breast biopsy (UG-VABB) in BI-RADS 4 A and B lesions.

Material and Methods: Between Agust 2014 to January 2018, fifty BI-RADS 4A and BI-RADS 4B lesions of 41 patients biopsied with 10G vacuum needle by a single radiologist were retrospectively evaluated.

Results: All patients were females and mean age of the 41 patients was 50.12 ± 8.63. Of all lesions, 84% was benign, 6% was ADH, 4% was in-situ cancer, and 6% was diagnosed as malign. Follow-up duration after VABB was 0-51 months and mean was 20.92 months. Complications were as vasovagal-induced seizure in 3 patients (7.3%) and intramammary hematoma in 16 patients (39%). Hematoma was diagnosed in 3 patients (7.3%) at the 6th month follow-up and it was resolved in all patients at the 12th month follow-up. Higher breast density resulted in higher hematoma rates. There was no relationship between lesion BI-RADS subgroups, lesion size or sample number and hematoma development. During the follow-up, residue lesion in 1 (2.4%) patient and scar tissue in 2 (4.9%) patients was detected.

Conclusion: US-guided VABB, with low complication rates and low scar development, is also a therapeutic excision method without remaining residue, which should be primarily preferred in smaller than 2 cm BI-RADS 4A and 4B lesions whose malignancy rates are relatively low. Hematoma, which is the most frequent complication, resorbed entirely in the 12th month in all patients.

Keywords: Ultrasound-guided, vacuum-aspiration biopsy, BI-RADS, complication, treatment

Cite this article as: Dinç Elibol F, Dere Y, Belli AK, Elibol C, Dere Ö, Nazlı O. Both a biopsy method and a therapeutic procedure in BI-RADS 4A and 4B lesions: Ultrasound-guided vacuum-assisted breast biopsy. Turk J Surg 2020; 36 (1): 65-71.


Ethics Committee Approval

This study had been approved by our medical school’s Institutional Reviews Board (number 04/III date 05.04.2018).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept - F.D.E.; Design - F.D.E., C.E., O.N.; Supervision - F.D.E., A.K.B.; Resource - F.D.E., Y.D., A.K.B., Ö.D.; Materials - Y.D., F.D.E.; Data Collection and/or Processing - C.E., Ö.D., Y.D., O.N.; Analysis and Interpretation - A.K.B., C.E., F.D.E.; Literature Review - F.D.E., C.E.; Writing Manuscript - F.D.E., O.N.; Critical Reviews - F.D.E., Y.D., A.K.B., C.E., Ö.D., O.N.

Conflict of Interest

All authors declare no conflict of interest and financial relationships.

Financial Disclosure

The authors declared that this study has received no financial support.