Page 113 - EJMO-9-2

Eurasian Journal of
Medicine and Oncology UGVAE of breast lesions

Table 3. Pathological and clinical follow-up findings and has been shown to be safe, as none of the patients in
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this study experienced major complications following the
Variable Total subjects (n=67; procedure.
1 lesion/subject)
Benign pathology results, n (%) UGVAE is generally well tolerated by patients, making
Papilloma 17 (25.4) it a favorable option for managing breast lesions. In the
Fibroadenoma 34 (50.7) present study, patient preference accounted for 22.4% of
the indications for UGVAE. Similarly, a separate study
Lipoma 1 (1.5) involving 134 patients reported that 94% preferred VAB
Pseudoangiomatous stromal hyperplasia 1 (1.5) over surgical intervention and indicated they would
Fibrocystic changes and adenosine 11 (16.4) recommend the procedure to others. In addition,
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Scar 1 (1.5) 85% of patients were fully satisfied with the cosmetic
Fat necrosis 1 (1.5) outcomes, and 54% reported experiencing no pain
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Tubular adenoma 1 (1.5) during the procedure. Overall, most patients tolerated
Clinical follow-up, n (%) the procedure well and expressed satisfaction with the
results, underscoring its acceptability and effectiveness as
Imaging 31 (46.3)
a minimally invasive option. 32
Clinic 23 (34.3)
The primary limitations of the ultrasound-guided
Surgery 4 (6)
vacuum-assisted system are post-procedural complications,
No follow-up 9 (13.4) which have hindered its broader use in managing breast
conditions. The most frequently reported complication is
histopathological results, which were distributed as follows: hematoma formation. In this study, 10 patients (14.9%)
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FA (50.7%; n = 34), papilloma (25.4%; n = 17), fibrocystic developed small hematomas and minor skin loss, which
changes and adenosis (16.4%; n = 11), tubular adenoma were effectively managed with conservative measures,
(1.5%; n = 1), lipoma (1.5%; n = 1), pseudoangiomatous including hematoma aspiration, compression, and skin
stromal hyperplasia (1.5%; n = 1), scar tissue (1.5%; sutures. Similar rates of post-procedural hematoma,
n = 1), and fat necrosis (1.5%; n = 1). At our institution, ranging from 9.4% to 10%, have been reported in other
UGVAE costs approximately 5000 Saudi Arabian Riyal studies. 29,33
(SAR) (i.e., ~ €1,280), compared to 15,000 SAR (i.e., ~ Over a follow-up period of 6 – 12 months, imaging or
€3,840) for a surgical lumpectomy. Over a follow-up clinical evaluations revealed no residual lesions in 81%
period of 6 – 12 months, imaging follow-up (ultrasound, of the patients in this study. These results align closely
mammography, or both) revealed no significant residuals with those reported in a comprehensive study by Lee
in 46.3% of cases (n = 31). Clinical follow-up, conducted et al., where 84.9% of patients showed no residual or
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by the referring physician, showed a satisfactory outcome recurrent lesions. However, the complete removal of
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and normal clinical examination in 34.3% (n = 23). Four masses observed on ultrasound does not always equate to
patients (6%) required subsequent surgeries, all of which complete histological clearance. In a study of 162 patients,
confirmed benign, concordant pathology results with residual tissue was identified in 16 cases during the
no residual lesion. Nine patients (13.4%) were lost to second follow-up, even though none was detected in the
follow-up. There was no statistically significant association first follow-up. This suggests that very small residual
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between the completeness of lesion excision (complete or tissue may not be immediately visible on post-excision
partial) and lesion size or the occurrence of complications ultrasound. Consequently, a slight margin of additional
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(p>0.05). excision might be necessary, even when imaging indicates
the lesion has been fully removed, to ensure complete
4. Discussion removal at the histological level. 36-38 In addition, UGVAE
The minimally invasive breast biopsy system has offers the advantage of being more cost-effective compared
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revolutionized the diagnosis and management of benign to surgical approaches. UGVAE is completed within a
breast conditions, offering a more advanced and efficient relatively short time frame. Although the duration was
approach. Lesions classified as probably benign often not documented in the present study, existing literature
require follow-up, which can lead to significant anxiety indicates that it typically takes approximately 30 min.
for patients. This study demonstrates that UGVAE is an In this study, the analysis revealed no statistically
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effective method for managing benign breast lesions. It is significant relationship between the initial sonographic
a minimally invasive procedure with cosmetic advantages size of the lesion and the occurrence of residual lesions that

Volume 9 Issue 2 (2025) 105 doi: 10.36922/ejmo.8436