Sonographic changes after removing all benign breast masses with sonographically guided vacuum-assisted biopsy

Background: Total removal of benign breast masses by vacuum-assisted biopsy (VAB) is now increasingly accepted as a treatment option. However, little is known about whether this procedure produces early changes on follow-up sonography and, if so, how often and what factors might influence them. Purpose: To evaluate sonographic changes after total removal of benign breast masses using sonographically guided VAB and to determine the influencing factors. Material and Methods: We evaluated sonographic changes prospectively 1 week, 1 month, and 6 months after biopsying 32 benign masses from which all sonographic evidence had been removed during sonographically guided directional VAB performed with 8- or 11-gauge needles. Procedural factors were documented and compared with sonographic findings. Results: At 1-week follow-up, hematomas were observed in 84% (27/32) of the lesions. After 1 month, while the hematomas had resolved in all but five lesions, focal new architectural distortion had developed in 26 (90%) lesions; 11 lesions were graded as severe, mimicking malignancy. After 6 months, 23 lesions with various degrees of architectural distortion were observed. Six of the 32 lesions (19%) contained a residual lesion. No statistically significant association between sonographic findings and procedural variables was identified, except between the degree of hematoma and lesion size. Conclusion: The total removal of benign breast masses using sonographically guided VAB frequently produces changes on follow-up sonography after 6 months. Although these changes failed to show statistical significance with procedural factors, a larger dedicated study is needed.