Vacuum-assisted excision (VAE) is an innovative non-invasive treatment option developed as an alternative for the treatment of certain breast tumors. Details on the efficacy, safety, indications, limitations, and clinical considerations of VAE are as follows:
Efficacy and safety: A meta-analysis of published studies found that VAE is highly effective in treating benign tumors, with a complete resection rate of up to 93 percent and a low recurrence rate of only 3.9 percent. In terms of safety, the complication rate was similar to that of open surgery (3.4-6.6 percent).
Complications found are divided into:
1. Common complications
o Minor bleeding or blood clots (6-9%)
o Pain and bruising (7-8%)
2. Severe complications
o Pneumothorax is very rare (only 2 cases reported in one study).
Indications for treatment of VAE The main indications for treatment are as follows:
1. Benign tumors smaller than 1.5-2 centimeters in size.
2. Fibroadenomas
3. Some high-risk lesions
4. Breast enlargement in men that is not very large
VAE is particularly suitable for:
• Patients who require treatment without open surgery
• In cases where diagnosis and treatment are required at the same time
• Lesions that are difficult to follow up with medical imaging
Limitations The efficiency of VAE decreases with increasing nodule size:
• Lumps smaller than 1.5 centimeters: 100 percent successful surgical resection rate.
• Lump size 1.5-2 cm: Complete surgical success rate 61 percent.
• Not recommended for lumps larger than 2 centimeters.
Advantages over open surgery
1. Treatment aspect
o No need for full anesthesia
o No need to stay in hospital
o The procedure takes a short time (10-60 minutes).
o Fast recovery
2. Aesthetic and satisfaction aspects
o The scar is smaller and more beautiful.
o Patients reported high levels of satisfaction.
3. Expenses
o The cost of treatment is lower than open surgery.
o Save on hospitalization related expenses
Technical Considerations There are important technical considerations involved in performing VAE:
1. Must be done under ultrasonic guidance.
2. Use a large needle (size 7-11) to remove enough tissue.
3. It requires collaboration between doctors from many fields, including:
o Radiologist
o surgeon
o Pathologist
Conclusion: VAE is a safe and effective innovative treatment for small benign breast tumors, providing similar outcomes to open surgery but with less trauma, better scar appearance, and lower cost. However, appropriate patient selection is crucial for treatment success, and large tumors may still require open surgery.
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