Benign radial scars, lesions characterised histologically by a fibroelastic core surrounded by stellate duct proliferation, cannot be differentiated from lesions with associated invasive or non-invasive carcinoma on imaging, and histological sampling is therefore mandatory. There is also extensive evidence of the frequency with which radial scars are associated with malignancy and with other lesions that have an associated risk of malignancy. The traditionally accepted management has been the surgical excision of all suspected radial scars because insufficient tissue was removed by standard biopsy techniques to exclude associated lesions. In more recent series, it has been shown that with extensive tissue sampling of such lesions with core biopsy and modern vacuum-assisted sampling devices, the presence of associated malignancy can be excluded, thus negating the need for surgical excision.

Fibroadenomas are most common benign tumour of the breast, usually affecting pre-menopausal women. The traditional treatment aimed at symptomatic relief and confirmation of the lesion's benign nature through open surgical excision and biopsy. The rise of ‘triple assessment’ in recent years has meant that a definitive benign diagnosis is now generally possible without recourse to open biopsy. But patients would still face undergoing open surgical excision for relief of symptoms. A third option is now available – that of percutaneous vacuum-assisted excision under local anaesthetic. Performed in a similar fashion to conventional percutaneous needle biopsy, the procedure can normally be completed within 15 min and offers quicker recovery times and better cosmetic outcome than traditional excision.