Deepali Poels, Daniel de Viana, Tirsa Van Wyngaard, Ian Bennett, Michael Law
{"title":"外科医生进行真空辅助乳腺活检/切除是良性和B3病变管理的可行范例-澳大利亚多中心经验。","authors":"Deepali Poels, Daniel de Viana, Tirsa Van Wyngaard, Ian Bennett, Michael Law","doi":"10.1002/wjs.70132","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Open excisional biopsy is currently the mainstay of management of a variety of benign and indeterminant (B3) breast lesions in Australasia. Vacuum assisted biopsy (VAB) and vacuum assisted excision (VAE) are being increasingly adopted into the management algorithm of such breast lesions internationally and are beginning to gain interest in Australasia. This study aims to review the experience and outcomes of a series of surgeon-performed ultrasound (US) guided VAB/VAEs undertaken by specialist breast surgeons in Australasian including its application and clinical deployment.</p><p><strong>Methods: </strong>An Australian multicenter trial of US-guided surgeon-performed VAB and VAE of benign or indeterminant breast lesions was conducted by three experienced breast surgeons from major breast services. The study involved prospectively collected data on 462 US-guided VAB/VAEs in 397 patients, in both outpatient and day case settings from 2015 to 2024. Malignant lesions proven on previous biopsies were excluded.</p><p><strong>Results: </strong>A total of 462 surgeon-performed US-guided vacuum-assisted procedures were undertaken in 397 patients. 137 procedures (29%) were performed as diagnostic VABs and 325 (71%) were undertaken as VAEs. Successful complete excision was achieved in 308 (95%) of cases where the intent of the procedure was complete excision, defined as absence of any lesion seen on US following the procedure and on subsequent interval US examination. Duration of follow-up ranged from 6 months to 9 years. The average size of lesions was 20 mm in the diagnostic VAB group and 11 mm in the VAE excision group. The average time for either procedure was approximately 15 min. No infection was reported and hematomas requiring surgical evacuation were < 1%.</p><p><strong>Conclusion: </strong>VAB/VAE are minimally invasive techniques well suited for management of variety of benign and B3 breast lesions. US guided VAB/VAE interventions are reliable, safe, and quick to perform in both day procedure or outpatient settings and can be readily learned by breast surgeons, especially those who already possess experience in breast interventional US. We have demonstrated its utility and viable deployment in contemporary Australian breast surgical practice and would advocate for its adoption in the Australasian surgical management algorithm, especially for small B3 lesions.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Surgeon Performed Vacuum Assisted Breast Biopsy/Excision Is a Viable Paradigm for the Management of Benign and B3 Lesions-An Australian Multicenter Experience.\",\"authors\":\"Deepali Poels, Daniel de Viana, Tirsa Van Wyngaard, Ian Bennett, Michael Law\",\"doi\":\"10.1002/wjs.70132\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Open excisional biopsy is currently the mainstay of management of a variety of benign and indeterminant (B3) breast lesions in Australasia. Vacuum assisted biopsy (VAB) and vacuum assisted excision (VAE) are being increasingly adopted into the management algorithm of such breast lesions internationally and are beginning to gain interest in Australasia. This study aims to review the experience and outcomes of a series of surgeon-performed ultrasound (US) guided VAB/VAEs undertaken by specialist breast surgeons in Australasian including its application and clinical deployment.</p><p><strong>Methods: </strong>An Australian multicenter trial of US-guided surgeon-performed VAB and VAE of benign or indeterminant breast lesions was conducted by three experienced breast surgeons from major breast services. The study involved prospectively collected data on 462 US-guided VAB/VAEs in 397 patients, in both outpatient and day case settings from 2015 to 2024. Malignant lesions proven on previous biopsies were excluded.</p><p><strong>Results: </strong>A total of 462 surgeon-performed US-guided vacuum-assisted procedures were undertaken in 397 patients. 137 procedures (29%) were performed as diagnostic VABs and 325 (71%) were undertaken as VAEs. Successful complete excision was achieved in 308 (95%) of cases where the intent of the procedure was complete excision, defined as absence of any lesion seen on US following the procedure and on subsequent interval US examination. Duration of follow-up ranged from 6 months to 9 years. The average size of lesions was 20 mm in the diagnostic VAB group and 11 mm in the VAE excision group. The average time for either procedure was approximately 15 min. No infection was reported and hematomas requiring surgical evacuation were < 1%.</p><p><strong>Conclusion: </strong>VAB/VAE are minimally invasive techniques well suited for management of variety of benign and B3 breast lesions. US guided VAB/VAE interventions are reliable, safe, and quick to perform in both day procedure or outpatient settings and can be readily learned by breast surgeons, especially those who already possess experience in breast interventional US. We have demonstrated its utility and viable deployment in contemporary Australian breast surgical practice and would advocate for its adoption in the Australasian surgical management algorithm, especially for small B3 lesions.</p>\",\"PeriodicalId\":23926,\"journal\":{\"name\":\"World Journal of Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-10-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/wjs.70132\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/wjs.70132","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Surgeon Performed Vacuum Assisted Breast Biopsy/Excision Is a Viable Paradigm for the Management of Benign and B3 Lesions-An Australian Multicenter Experience.
Background: Open excisional biopsy is currently the mainstay of management of a variety of benign and indeterminant (B3) breast lesions in Australasia. Vacuum assisted biopsy (VAB) and vacuum assisted excision (VAE) are being increasingly adopted into the management algorithm of such breast lesions internationally and are beginning to gain interest in Australasia. This study aims to review the experience and outcomes of a series of surgeon-performed ultrasound (US) guided VAB/VAEs undertaken by specialist breast surgeons in Australasian including its application and clinical deployment.
Methods: An Australian multicenter trial of US-guided surgeon-performed VAB and VAE of benign or indeterminant breast lesions was conducted by three experienced breast surgeons from major breast services. The study involved prospectively collected data on 462 US-guided VAB/VAEs in 397 patients, in both outpatient and day case settings from 2015 to 2024. Malignant lesions proven on previous biopsies were excluded.
Results: A total of 462 surgeon-performed US-guided vacuum-assisted procedures were undertaken in 397 patients. 137 procedures (29%) were performed as diagnostic VABs and 325 (71%) were undertaken as VAEs. Successful complete excision was achieved in 308 (95%) of cases where the intent of the procedure was complete excision, defined as absence of any lesion seen on US following the procedure and on subsequent interval US examination. Duration of follow-up ranged from 6 months to 9 years. The average size of lesions was 20 mm in the diagnostic VAB group and 11 mm in the VAE excision group. The average time for either procedure was approximately 15 min. No infection was reported and hematomas requiring surgical evacuation were < 1%.
Conclusion: VAB/VAE are minimally invasive techniques well suited for management of variety of benign and B3 breast lesions. US guided VAB/VAE interventions are reliable, safe, and quick to perform in both day procedure or outpatient settings and can be readily learned by breast surgeons, especially those who already possess experience in breast interventional US. We have demonstrated its utility and viable deployment in contemporary Australian breast surgical practice and would advocate for its adoption in the Australasian surgical management algorithm, especially for small B3 lesions.
期刊介绍:
World Journal of Surgery is the official publication of the International Society of Surgery/Societe Internationale de Chirurgie (iss-sic.com). Under the editorship of Dr. Julie Ann Sosa, World Journal of Surgery provides an in-depth, international forum for the most authoritative information on major clinical problems in the fields of clinical and experimental surgery, surgical education, and socioeconomic aspects of surgical care. Contributions are reviewed and selected by a group of distinguished surgeons from across the world who make up the Editorial Board.