{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T08:28:09Z","timestamp":1787646489969,"version":"build-2736575974"},"reference-count":17,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Breast cancer is the most common malignancy among women worldwide. Vacuum-assisted breast biopsy (VABB) has emerged as a minimally invasive alternative to surgical excision, but it may cause post-biopsy scarring that could mimic or obscure malignancies on follow-up imaging. This study aimed to evaluate the imaging characteristics, evolution, and clinical implications of post-VABB scar formation. Methods: We conducted a retrospective study of patients who underwent mammographic or magnetic resonance imaging-guided VABB at our institution between January 2010 and December 2020 and whose follow-up report describes a post-biopsy scar. Patients with malignant or high-risk lesions requiring subsequent surgery or prior breast surgery were excluded. Post-biopsy follow-up mammograms and ultrasounds were reviewed by a fellowship-trained breast radiologist for scar formation, visibility across imaging modalities, and evolution over time. Statistical analysis was performed to assess associations between scar detection and patient or lesion characteristics. Results: Thirty-seven patients (39 lesions) with documented post-biopsy scarring on follow-up imaging reports met the study inclusion criteria. The mean age at biopsy was 51.97 \u00b1 12.40 years. Lesions were almost equally distributed between the right and left breasts, with 19 cases involving the right breast (48.7%) and 20 cases involving the left breast (51.3%). Most cases did not need any workup, except for six cases, where two required further biopsy and four required short-term follow-up. No malignancy was detected during the available follow-up or additional evaluation. Twenty-two scars regressed over time. The estimated mean time to scar regression was 69.47 months. Conclusions: Post-biopsy scarring was documented in a small subset of our institution\u2019s VABB cases over the study period and may resemble malignant findings, particularly on tomosynthesis. Awareness of typical scar characteristics, careful documentation of biopsy sites, and correlation with clip markers are essential to avoid unnecessary interventions.<\/jats:p>","DOI":"10.3390\/diagnostics16172705","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T08:00:48Z","timestamp":1787644848000},"page":"2705","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vacuum-Assisted Breast Biopsy and Post-Biopsy Scarring: Implications for Imaging Interpretation"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5051-4282","authenticated-orcid":false,"given":"Omar El","family":"Sardouk","sequence":"first","affiliation":[{"name":"Department of Diagnostic Radiology, American University of Beirut, Beirut P.O. Box 11-0236, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9053-5866","authenticated-orcid":false,"given":"Joe","family":"Rizkallah","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, American University of Beirut, Beirut P.O. Box 11-0236, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah Abou","family":"Zeid","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, American University of Beirut, Beirut P.O. Box 11-0236, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghina","family":"Berjawi","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, American University of Beirut, Beirut P.O. Box 11-0236, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4076-2224","authenticated-orcid":false,"given":"Lara","family":"Nassar","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, American University of Beirut, Beirut P.O. Box 11-0236, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","unstructured":"GLOBOCAN (2022). GLOBOCAN Lebanon 2022, GLOBOCAN."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"10732748211039443","DOI":"10.1177\/10732748211039443","article-title":"Overview in Breast Cancer Screening in Lebanon","volume":"28","author":"Sbaity","year":"2021","journal-title":"Cancer Control"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1016\/j.jacr.2021.04.021","article-title":"Breast Cancer Screening Recommendations Inclusive of All Women at Average Risk: Update from the ACR and Society of Breast Imaging","volume":"18","author":"Monticciolo","year":"2021","journal-title":"J. Am. Coll. Radiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.crad.2010.01.008","article-title":"Image-guided breast biopsy: State-of-the-art","volume":"65","author":"Wilson","year":"2010","journal-title":"Clin. Radiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e739","DOI":"10.1016\/j.ejrad.2012.01.033","article-title":"Interventional bleeding, hematoma and scar-formation after vacuum-biopsy under stereotactic guidance: Mammotome\u00ae-system 11g\/8g vs. ATEC\u00ae-system 12g\/9g","volume":"81","author":"Schaefer","year":"2012","journal-title":"Eur. J. Radiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"326","DOI":"10.5152\/dir.2015.14522","article-title":"Vacuum-assisted stereotactic breast biopsy in the diagnosis and management of suspicious microcalcifications","volume":"22","author":"Esen","year":"2016","journal-title":"Diagn. Interv. Radiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"9540","DOI":"10.1007\/s00330-021-08060-z","article-title":"Effectiveness of percutaneous vacuum-assisted excision (VAE) of breast lesions of uncertain malignant potential (B3 lesions) as an alternative to open surgical biopsy","volume":"31","author":"Giannotti","year":"2021","journal-title":"Eur. Radiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"14","DOI":"10.21037\/tbcr-23-12","article-title":"Breast biopsy techniques in a global setting-clinical practice review","volume":"4","author":"Silva","year":"2023","journal-title":"Transl. Breast Cancer Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/j.crad.2006.03.008","article-title":"Scar formation after stereotactic vacuum-assisted core biopsy of benign breast lesions","volume":"61","author":"Yazici","year":"2006","journal-title":"Clin. Radiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"753","DOI":"10.2214\/ajr.174.3.1740753","article-title":"Mammographic Abnormalities Caused by Percutaneous Stereotactic Biopsy of Histologically Benign Lesions Evident on Follow-Up Mammograms","volume":"174","author":"Lamm","year":"2000","journal-title":"Am. J. Roentgenol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1002\/cncr.11887","article-title":"Stereotactic vacuum-assisted breast biopsy in 2874 patients: A multicenter study","volume":"100","author":"Kettritz","year":"2004","journal-title":"Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"76","DOI":"10.4274\/ejbh.galenos.2022.2022-9-3","article-title":"Radial Scars Without Atypia Diagnosed at Percutaneous Core Needle Breast Biopsy: Support for Imaging Surveillance","volume":"19","author":"Polat","year":"2023","journal-title":"Eur. J. Breast Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.2214\/AJR.15.14628","article-title":"Architectural Distortion on Mammography: Correlation with Pathologic Outcomes and Predictors of Malignancy","volume":"205","author":"Bahl","year":"2015","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"667","DOI":"10.2214\/AJR.06.0413","article-title":"Developing Asymmetry Identified on Mammography: Correlation with Imaging Outcome and Pathologic Findings","volume":"188","author":"Leung","year":"2007","journal-title":"Am. J. Roentgenol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"4797","DOI":"10.1007\/s00330-017-4851-7","article-title":"Stereotactic core needle breast biopsy marker migration: An analysis of factors contributing to immediate marker migration","volume":"27","author":"Jain","year":"2017","journal-title":"Eur. Radiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.acra.2019.03.022","article-title":"Immediate Migration of Biopsy Clip Markers After Upright Digital Breast Tomosynthesis-Guided Vacuum-Assisted Core Biopsy","volume":"27","author":"Teichgraeber","year":"2020","journal-title":"Acad. Radiol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/17\/2705\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T08:11:13Z","timestamp":1787645473000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/17\/2705"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,25]]},"references-count":17,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["diagnostics16172705"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16172705","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,25]]}}}