Ultrasound-Guided Vacuum-Assisted Excision (VAE) in Breast Lesion Management: An Experimental Comparative Study of Two Different VAE Devices Across Various Aspiration Levels and Window Sizes.

Background/

Objectives: Vacuum-assisted excision (VAE) is a minimally invasive technique for breast tumor treatment, offering precision, comfort, and quick recovery. It is widely used for benign breast lesions and is playing an increasingly important role in the therapeutic management of non-surgical patients or patients who refuse surgery. Optimal outcomes require an understanding of device features to tailor treatment to each lesion. The Mammotome® Elite 10G operates in a fixed mode, while the Mammotome® Revolve EX 8G offers multiple aspiration levels and aperture windows for greater versatility. This study analyzed the specimen features (weight and length), comparing the weight obtained from two different VAE systems to aid the appropriate selection of a device based on the clinical setting. It also determined the number of specimens needed to achieve the 4 g diagnostic threshold.

Methods: The Mammotome® Elite 10G and the Mammotome® Revolve EX were evaluated under controlled conditions. For Mammotome® Revolve EX, combinations of five aspiration levels and three aperture lengths (12 mm, 18 mm, and 25 mm) were tested. Twelve samples were collected from a chicken breast phantom for each setting. Specimen weights and the minimum excisions required to reach the 4 g threshold were analyzed.

Results: The mean weight per sample for the Mammotome® Elite 10G was 0.16 ± 0.04 g. For the Mammotome® Revolve EX, the weights increased with aperture size and aspiration level, ranging from a minimum of 0.132 ± 0.028 g (a window length of 12 mm and aspiration level 1) to a maximum of 0.407 ± 0.055 g (a window length of 25 mm and aspiration level 5). The 25 mm window at aspiration level 5 achieved the 4 g threshold in as few as 10 samples. By comparison, the Mammotome® Elite required up to 26 samples.

Conclusions: Compared to the Mammotome Elite, Mammotome® Revolve EX offers superior versatility and efficiency, reducing patient discomfort by minimizing the required samples. Its technical advantages make it a valuable tool for both diagnostic and therapeutic applications.