To investigate the feasibility of vacuum-assisted core-needle biopsy of intraductal breast lesions under the guidance of fiberoptic ductoscopy and ultrasound.

The clinical data of 75 patients with intraductal breast lesions detected by fiberoptic ductoscopy and treated by surgery in the Guangzhou Women and Children’s Medical Center from January 2014 to December 2016 were retrospectively analyzed. Twenty-nine patients underwent vacuum-assisted core-needle biopsy (minimally invasive surgery group) and 46 patients underwent conventional ductectomy (conventional surgery group). The operation time, postoperative pathological results, length of the incision and patient satisfaction with the aesthetic appearance of the incision were analyzed. Because of the non-normal distribution, the indexes including age, operation time and length of the incision were expressed by M(P₂₅-P₇₅) and analyzed by nonparametric test of two independent samples. The rates were compared using χ² test.

The operation time in minimally invasive surgery group was 10.0 (8.0-15.0) min, which was significantly lower than 36.5(32.0~40.3) min in conventional surgery group (Z=-7.267, P<0.001). The pathological detection rate in minimally invasive surgery group was 100.0% (29/29), which was significantly higher than 71.7% (33/46) in conventional surgery group (χ²=9.914, P=0.002). The length of the incision was 0.5 (0.5-0.7) cm in minimally invasive surgery group, 2.0 (2.0-3.0) cm in conventional surgery group, indicating a significant difference (Z=-7.438, P<0.001). With regards to aesthetic appearance of the incision, patient satisfaction rate was 96.6% (28/29) in minimally invasive surgery group, significantly higher than 76.1% (35/46) in conventional surgery group (χ²=4.124, P=0.042). All patients were followed up for median 27 months (range: 12-47 months). There was no recurrence in minimally invasive surgery group and one patient had reoperation six months later in conventional surgery group.

Vacuum-assisted core-needle biopsy under the guidance of fiberoptic ductoscopy and ultrasound has the advantages of minimally invasive surgery, small incision with aesthetic appearance, short operation time and high accuracy, which is feasible in the treatment of intraductal breast lesions.