[en] &lt;p&gt;The BI-RADS classification system was developed to standardize the description of mammography, ultrasonography, and magnetic resonance imaging of the breast, providing accurate information about breast lesions to assist in patient treatment and follow-up. BI-RADS category 4A indicates lesions suspicious of malignancy that require biopsy. Breast vacuum biopsy is a widely used technique for evaluating suspicious lesions, providing a precise analysis of lesion characteristics and the identification of cancerous cells. This narrative literature review analyzed the applicability of vacuum biopsy in the context of BI-RADS 4A classification. Four relevant articles were selected after searching the Virtual Health Library, using the SCIELO and MEDLINE databases. The analysis of these articles revealed that vacuum biopsy is effective and safe in diagnosing stage 4A breast cancer lesions. The use of vacuum suction during the procedure allows for a more comprehensive collection of solid tissue samples, reducing the need for procedure repetition and providing suitable materials for histopathological analysis. Additionally, vacuum biopsy is performed under image guidance, such as ultrasonography, mammography, magnetic resonance imaging, and computed tomography, contributing to a more accurate diagnosis and more effective treatment planning. Vacuum biopsy has proven effective not only in diagnosing breast lesions but also thyroid and lung lesions. Its use has increased in contemporary clinical practice due to reliability and a variety of clinical applications. Reviewed studies reported low rates of severe risk and minimal complications related to the vacuum biopsy procedure, such as bleeding at the lesion site, pain, postoperative sensitivity, and hematomas. No reports of serious complications were found, and mild complications were considered tolerable and generally unidentifiable after 12 months. In summary, breast vacuum biopsy, known as VABB, is a viable option for the diagnosis and treatment of breast tumors. It is a minimally invasive technique capable of avoiding additional surgeries in benign lesions classified as BI-RADS 4A and 4B, provided they are smaller than 2 cm and proven benign by pathological analysis. It has low complication rates and demonstrates therapeutic efficacy. Ultrasound-guided VABB is recommended as the initial approach due to its ease of application, ability to provide adequate samples, and therapeutic effects.&lt;/p&gt;

[pt] &lt;p&gt;O sistema de classifica&ccedil;&atilde;o BI-RADS foi desenvolvido para padronizar a descri&ccedil;&atilde;o de imagens de mamografia, ultrassonografia e resson&acirc;ncia magn&eacute;tica da mama, fornecendo informa&ccedil;&otilde;es precisas sobre les&otilde;es mam&aacute;rias para auxiliar no tratamento e acompanhamento dos pacientes. A categoria 4A do BI-RADS indica les&otilde;es suspeitas de malignidade que requerem bi&oacute;psia. A bi&oacute;psia a v&aacute;cuo de mama &eacute; uma t&eacute;cnica amplamente utilizada para avaliar les&otilde;es suspeitas, proporcionando uma an&aacute;lise precisa das caracter&iacute;sticas da les&atilde;o e identifica&ccedil;&atilde;o de c&eacute;lulas cancer&iacute;genas. Esta revis&atilde;o narrativa da literatura analisou a aplicabilidade da bi&oacute;psia a v&aacute;cuo no contexto da classifica&ccedil;&atilde;o BI-RADS 4A. Foram selecionados 4 artigos relevantes ap&oacute;s busca na Biblioteca Virtual em Sa&uacute;de, utilizando as bases SCIELO e MEDLINE. A an&aacute;lise desses artigos revelou que a bi&oacute;psia a v&aacute;cuo &eacute; eficaz e segura no diagn&oacute;stico de les&otilde;es do estadiamento 4A do c&acirc;ncer de mama. A utiliza&ccedil;&atilde;o de suc&ccedil;&atilde;o a v&aacute;cuo durante o procedimento permite a coleta de amostras de tecidos s&oacute;lidos de forma mais completa, reduzindo a necessidade de repeti&ccedil;&atilde;o do procedimento e fornecendo materiais adequados para an&aacute;lise histopatol&oacute;gica. Al&eacute;m disso, a bi&oacute;psia a v&aacute;cuo &eacute; realizada sob orienta&ccedil;&atilde;o de imagens, como ultrassonografia, mamografia, resson&acirc;ncia magn&eacute;tica e tomografia computadorizada, o que contribui para um diagn&oacute;stico mais preciso e um planejamento de tratamento mais efetivo. A bi&oacute;psia a v&aacute;cuo tem se mostrado eficaz n&atilde;o apenas no diagn&oacute;stico de les&otilde;es mam&aacute;rias, mas tamb&eacute;m no diagn&oacute;stico de les&otilde;es tireoidianas e pulmonares. Sua utiliza&ccedil;&atilde;o tem aumentado na pr&aacute;tica cl&iacute;nica contempor&acirc;nea devido &agrave; confiabilidade e variedade de aplica&ccedil;&otilde;es cl&iacute;nicas. Os estudos revisados relataram taxas de risco severo e complica&ccedil;&otilde;es m&iacute;nimas relacionadas ao procedimento de bi&oacute;psia a v&aacute;cuo, como sangramento no local lesionado, dor, sensibilidade p&oacute;s-operat&oacute;ria e hematomas. N&atilde;o foram encontrados relatos de complica&ccedil;&otilde;es graves, e as complica&ccedil;&otilde;es leves foram consideradas toler&aacute;veis e geralmente n&atilde;o identific&aacute;veis ap&oacute;s 12 meses. Em resumo, a bi&oacute;psia a v&aacute;cuo de mama, conhecida como VABB, &eacute; uma op&ccedil;&atilde;o vi&aacute;vel para o diagn&oacute;stico e tratamento de tumores mam&aacute;rios. &Eacute; uma t&eacute;cnica minimamente invasiva, capaz de evitar cirurgias adicionais em les&otilde;es benignas classificadas como BI-RADS 4A e 4B, desde que sejam menores que 2 cm e comprovadamente benignas por an&aacute;lise patol&oacute;gica. Apresenta baixas taxas de complica&ccedil;&otilde;es e demonstra efic&aacute;cia terap&ecirc;utica. O VABB guiado por ultrassom &eacute; recomendado como abordagem inicial devido &agrave; sua facilidade de aplica&ccedil;&atilde;o, capacidade de fornecer amostras adequadas e efeitos terap&ecirc;uticos.&lt;/p&gt;