{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:54:30Z","timestamp":1781844870987,"version":"3.54.5"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically summarize study-level factors associated with postoperative hematoma after ultrasound-guided vacuum-assisted breast lesion excision(VAE) using a vacuum-assisted breast biopsy (VABB) system, and to organize the available evidence according to a novel T-P-B framework comprising tumor-related, position-related, and breast- or peri-procedural management-related factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic search was conducted in PubMed, China National Knowledge Infrastructure, Wan fang Data, VIP Database, and Elsevier Clinical Key for studies published between January 1995 and October 2025. Observational studies investigating risk factors for hematoma after VAE using a VABB system were included. Study-derived exposure categories and cutoff values were retained. Study quality was assessed using the Newcastle\u2013Ottawa Scale (NOS). Meta-analysis was performed using R (version 4.5.1). Effect sizes were expressed as odds ratios (ORs) with corresponding 95% confidence intervals (CIs) and were pooled using the inverse-variance method. Heterogeneity was assessed using the I\u00b2 statistic, and a random-effects model was applied. Sensitivity analysis was conducted by sequentially excluding individual studies (leave-one-out analysis). A two-sided\n                      <jats:italic>p<\/jats:italic>\n                      value &amp;lt; 0.05 was considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 11 retrospective studies involving 3,516 patients who underwent VAE using a VABB system were included, among whom 444 cases of postoperative hematoma were reported. Five study-level factors were identified. Meta-analysis demonstrated that, within the T dimension, tumor numbers (OR = 4.21, 95% CI = 2.59\u20136.85), numbers of cutting passes(OR=3.87,95%CI=2.16-6.95)were significantly associated with hematoma formation. Within the P dimension, non-moderate tumor depth, including superficial or deep tumor, was associated with postoperative hematoma (OR = 4.39, 95% CI: 1.21\u201315.92), as was higher vascularity grade (OR = 2.60, 95% CI: 1.42\u20134.76). Within the B dimension, postoperative compression duration &amp;lt;48\u00a0h was associated with hematoma formation (OR = 4.34, 95% CI: 2.53\u20137.45). Sensitivity analyses showed generally consistent directions of association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis identified five study-level factors associated with postoperative hematoma after VAE using a VABB system: tumor numbers, a higher number of cutting passes, non-moderate tumor depth including superficial or deep tumor, higher vascularity grade, and postoperative compression duration &amp;lt;48\u00a0h. The T-P-B framework may provide a clinically interpretable structure for organizing these factors and informing perioperative risk assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1828439","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:29:52Z","timestamp":1781843392000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Study-level factors associated with hematoma after ultrasound-guided vacuum-assisted breast lesion excision: a systematic review and meta-analysis using a T-P-B framework"],"prefix":"10.3389","volume":"16","author":[{"given":"Yunzhi","family":"Shen","sequence":"first","affiliation":[{"name":"Dalian Medical University","place":["Dalian, China"]},{"name":"Department of Thyroid and Breast Surgery,People\u2019s Hospital of Liaoning Province","place":["Shenyang, 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Hospital, China Medical University","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pingdong","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Liaoyang County Central Hospital","place":["Liaoyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxia","family":"Jiang","sequence":"additional","affiliation":[{"name":"Graduate Training Base of Liaoning Provincial People\u2019s Hospital, Jinzhou Medical University","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Fei","sequence":"additional","affiliation":[{"name":"Department of Thyroid and Breast Surgery,People\u2019s Hospital of Liaoning Province","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Thyroid and Breast Surgery,People\u2019s 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