Clinical efficacy and psychological benefits of ultrasound-guided vacuum-assisted excision in outpatient management of benign breast lesions.

OBJECTIVE

To comprehensively assess the clinical efficacy, peri-procedure safety, and psychological impact of VAE for benign breast lesions.

METHODS

This retrospective observational study included 1413 patients (2008 benign breast lesions) who underwent outpatient VAE between October 2020 and January 2025. Demographic data, lesion characteristics, histopathology, and procedure duration were extracted from electronic medical records (EMRs). Post-procedural complications, pre-/post-procedural anxiety levels (using SAS), and patient satisfaction were retrieved from clinician-documented follow-up records.

RESULTS

Most patients (64.26 %) were aged 31-50 years, and all were female. Among 2008 excised lesions, solitary lesions occurred in 59.45 % of patients, with the upper outer quadrant being the most frequent location (44.42 %). Fibroadenoma was the most common diagnosis (78.14 %). High-risk lesions (sclerosing adenosis, papilloma, papillomatosis, and atypical hyperplasia) accounted for 3.04 %. Additionally, carcinoma in situ and invasive carcinoma were identified in 5 cases (0.25 %). The mean procedure duration was 23.33 ± 9.26 min, with low post-procedure complication rates (hemorrhage: 18.54 %, defined as incisional oozing soaking part of the innermost dressing, all resolving spontaneously without intervention; hematoma: 16.63 %, almost all managed with observation/warm compresses; infection: 0.57 %). Pain was reported by 81.32 % of patients post-procedurally, but only 7.57 % required oral analgesics and 0.36 % were not relieved by oral analgesics. 98.91 % achieved excellent cosmetic outcomes. Patient satisfaction was high (98.94 %). Pre-procedure anxiety scores decreased post-procedurally (mean score: 47.47 ± 8.20 vs. 43.27 ± 7.80, P < 0.001), with 72.03 % anxiety remission rate.

CONCLUSION

VAE achieves excellent efficacy and safety with psychological benefits, supporting outpatient adoption. Long-term validation studies are warranted.