THE ROLE OF VACUUM ASPIRATION BIOPSY IN THE DIFFERENTIAL DIAGNOSIS OF FOCAL LESIONS OF THE MAMMARY GLANDS

to determine the role of vacuum aspiration biopsy in the differential diagnosis of focal pathology of the mammary gland.
a retrospective study was conducted in 57 women aged 19 to 77 years (mean age 39.7±13.2 years) who sought medical care in the period from 2018 to 2021 with complaints of a palpable formation for dynamic observation or screening examination. All patients had hypo- and/or anechoic focal lesions in the mammary glands visualized by ultrasound examination (US) and the BI-RADS category 2–4 was established. To clarify the diagnosis, a vacuum aspiration biopsy (VAB) procedure under ultrasound control was performed followed by morphological examination. A total of 90 focal lesions were examined.
of 90 examined focal lesions of the mammary glands, diagnosed in 57 women, 86 (95.5%) lesions were histopathologically benign pathology. In 58.8% of focal lesions, fibroadenoma (FA) was verified. In 41.5% of foci, it was combined with other benign changes, including high-risk ones. The malignant nature of the formation was diagnosed in 4 (4.5%) cases, while based on ultrasound, a malignant neoplasm was assumed and the BI-RADS category 4c was established in only 2 of them. Simple FA (34.4%), sclerosing adenosis (8.9%) and atypical hyperplasia (1.1%), as well as their combination (24.4%), often do not have specific signs during ultrasound diagnostics and in most cases are visualized as typical benign FA, which complicates the differential diagnosis of these pathologies and requires morphological verification of the diagnosis.
Ultrasound based on a combination of ultrasound signs does not allow for a detailed determination of the nature of a focal lesion. Ultrasound-guided VA, being a minimally invasive technique, makes it possible, without surgical intervention, to obtain the best material for histological examination and thus demonstrates a higher level of accuracy in the differential diagnosis of focal lesions of the mammary glands and allows for the deficiencies of ultrasound diagnostics to be compensated for.