Management of Intraductal Papilloma Using Vacuum Assisted Breast Surgery (VABB/VAE):- A Single Institute Study

Abstract

Introduction: - Intraductal papilloma, although benign, has a high upgradation rate to malignant breast cancer. Surgical excision is necessary, but the rate of complications is high. Ultrasound-guided vacuum-assisted excision (US-VAE) is a new technique derived from the VABB biopsy method that can give better cosmetic results as well as fewer surgical complications. Objectives:- Understanding the utility of US-VAE in the diagnosis and treatment of intraductal papillomas of the breast. Methodology:- With permission from the Ethics Board and consent of the patients, 47 patients were recruited to undergo the US-VAE procedure. USG was used to stage the tumor with Mammography and CNB as needed and patients with single duct or adjacent duct lesions were included while the rest, including patients with malignant changes, were excluded. The Bard VABB biopsy machine and the 7G probe were used by highly trained breast surgeons to perform the procedure. Results:- Of the 47 patients included, 32 patients under local anesthesia were operated while others were under general anesthesia according to the preference of the patient and the level of apprehension. The patients received oral paracetamol as the only painkiller for 5 days. Only 3 patients required prolonged analgesics. 7 patients had prolonged bruising (lasting more than one week), which was the most common complication. All patients (100%) were happy with the cosmetic result after the procedure. Conclusions- The advantages of VABB-guided surgery are faster recovery, scarless procedure, and the ability to perform the surgery under local anesthesia, making it an OPD and daycare procedure. Key words:- Intraductal Papilloma; US-VAE; Excision; Surgery; VABB; Upgradation; Cosmesis