Korean Societies Issue First Local Guidance on Breast VAE
The Korean Breast Cancer Society and the Korean Association of Breast and Thyroid Surgeons issued local guidance calling for selective use of vacuum-assisted excision after assessment of each breast lesion.
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The Korean Breast Cancer Society and the Korean Association of Breast and Thyroid Surgeons released guidance on vacuum-assisted excision, or VAE, that combines international evidence with Korea's clinical setting. VAE removes a breast lesion with a vacuum-assisted device under imaging guidance through a minimally invasive procedure.
The two societies framed VAE as a selective option, not a routine response whenever a lesion is found. Their guidance directs clinicians to consider the lesion's characteristics, symptoms, size changes and the patient's preference, while using follow-up observation as the basic approach for benign lesions.
What the new guidance says
The two societies made tissue diagnosis before VAE the general rule so that clinicians can identify the nature of a lesion first. They allowed proceeding directly to VAE without a prior biopsy only as a limited exception.
For a lesion suspected or diagnosed to be breast cancer, the societies did not position VAE as a replacement for standard surgery. The purpose of the guidance is to support case-specific clinical judgment rather than broadly expand or restrict use of the procedure.
Limits and patient context
The guidance distinguishes observation from removal: the societies set follow-up observation as the starting approach for benign lesions and reserved VAE for selected circumstances. Symptoms, lesion growth and patient preference can enter the decision, but no single factor makes VAE an automatic choice.
The reports do not specify rates for effectiveness, side effects or recovery, so they cannot support a numerical expectation for an individual patient. Because individual variation matters, patients should consult a qualified physician about possible side effects, recovery considerations and whether biopsy, observation or another treatment pathway fits their case.
Questions for the consultation
Patients can ask the clinician whether imaging and tissue diagnosis indicate a benign lesion and why follow-up observation or removal is being proposed. They can also ask how symptoms, any size change and their own preference affect the recommendation.
If VAE is proposed, patients can consult the clinician about whether a biopsy should come first and whether the case fits the limited circumstances for proceeding without one. When cancer is suspected or diagnosed, they should ask about the standard surgical pathway rather than treating VAE as its substitute.
Frequently asked questions
Does every benign breast lesion need to be removed?
No. The two societies set follow-up observation as the basic approach for benign lesions and recommend considering VAE selectively according to lesion characteristics, symptoms, size changes and patient preference. A qualified physician can help apply those factors to an individual case.
Do I need a biopsy before vacuum-assisted excision?
The guidance makes tissue diagnosis before VAE the general rule. Going directly to VAE without a prior biopsy may be considered only in limited circumstances.
Can VAE replace standard surgery if breast cancer is suspected?
The societies did not position VAE as a substitute for standard surgery when a lesion is suspected or diagnosed to be breast cancer. Patients in that situation should consult a qualified physician about the standard surgical treatment pathway.
Questions to take to your breast consultation
- Do imaging and tissue findings indicate that my lesion is benign?
- Why are you recommending follow-up observation or removal in my case?
- Should I have a biopsy before VAE?
- How do my symptoms, lesion size changes and preferences affect the decision?
- What side effects and recovery considerations should I discuss for my individual situation?
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