[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;

[es] &lt;p&gt;El sistema de clasificaci&oacute;n BI-RADS fue desarrollado para estandarizar la descripci&oacute;n de im&aacute;genes de mamograf&iacute;a, ecograf&iacute;a y resonancia magn&eacute;tica de mama, proporcionando informaci&oacute;n precisa sobre las lesiones mamarias para ayudar en el tratamiento y seguimiento de los pacientes. La categor&iacute;a 4A del BI-RADS indica lesiones sospechosas de malignidad que requieren biopsia. La biopsia asistida por vac&iacute;o de mama es una t&eacute;cnica ampliamente utilizada para evaluar lesiones sospechosas, proporcionando un an&aacute;lisis preciso de las caracter&iacute;sticas de la lesi&oacute;n y la identificaci&oacute;n de c&eacute;lulas cancerosas. Esta revisi&oacute;n narrativa de la literatura analiz&oacute; la aplicabilidad de la biopsia asistida por vac&iacute;o en el contexto de la clasificaci&oacute;n BI-RADS 4A. Se seleccionaron cuatro art&iacute;culos relevantes tras una b&uacute;squeda en la Biblioteca Virtual en Salud, utilizando las bases de datos SCIELO y MEDLINE. El an&aacute;lisis de estos art&iacute;culos revel&oacute; que la biopsia asistida por vac&iacute;o es eficaz y segura en el diagn&oacute;stico de lesiones de c&aacute;ncer de mama en estadio 4A. El uso de succi&oacute;n por vac&iacute;o durante el procedimiento permite una recolecci&oacute;n m&aacute;s completa de muestras de tejido s&oacute;lido, reduciendo la necesidad de procedimientos repetidos y proporcionando materiales adecuados para el an&aacute;lisis histopatol&oacute;gico. Adem&aacute;s, la biopsia asistida por vac&iacute;o se realiza bajo gu&iacute;a de im&aacute;genes, como ecograf&iacute;a, mamograf&iacute;a, resonancia magn&eacute;tica y tomograf&iacute;a computarizada, lo que contribuye a un diagn&oacute;stico m&aacute;s preciso y una planificaci&oacute;n de tratamiento m&aacute;s efectiva. La biopsia asistida por vac&iacute;o ha demostrado ser eficaz no solo en el diagn&oacute;stico de lesiones mamarias, sino tambi&eacute;n en el diagn&oacute;stico de lesiones tiroideas y pulmonares. Su uso ha aumentado en la pr&aacute;ctica cl&iacute;nica contempor&aacute;nea debido a su fiabilidad y la variedad de aplicaciones cl&iacute;nicas. Los estudios revisados reportaron tasas de riesgo bajo y complicaciones m&iacute;nimas relacionadas con el procedimiento de biopsia asistida por vac&iacute;o, como sangrado en el sitio de la lesi&oacute;n, dolor, sensibilidad postoperatoria y hematomas. No se encontraron informes de complicaciones graves, y las complicaciones leves se consideraron tolerables y generalmente imperceptibles despu&eacute;s de 12 meses. En resumen, la biopsia asistida por vac&iacute;o de mama (VABB) es una opci&oacute;n viable para el diagn&oacute;stico y tratamiento de tumores mamarios. Es una t&eacute;cnica m&iacute;nimamente invasiva que puede evitar cirug&iacute;as adicionales en lesiones benignas clasificadas como BI-RADS 4A y 4B, siempre que sean menores de 2 cm y se compruebe su benignidad mediante an&aacute;lisis patol&oacute;gico. Presenta bajas tasas de complicaciones y demuestra eficacia terap&eacute;utica. Se recomienda la VABB guiada por ultrasonido como enfoque inicial debido a su facilidad de aplicaci&oacute;n, capacidad para proporcionar muestras adecuadas y efectos terap&eacute;uticos.&lt;/p&gt;