This study examined the outcomes of vacuum-assisted biopsy (VAB) for assessing breast microcalcifications. Conducted on 257 patients, most were classified under BI-RADS 4B (80.2%) and 4C (17.1%). More than half (57.6%) had microcalcifications distributed in multiple groups, with the most common morphology being punctate amorphous (42.4%).

Pathological results showed that 70% of patients had benign findings, while 26.8% had malignant features. The distribution of malignancies varied across BI-RADS categories: in the 4B category, 32 cases were malignant, and 166 were benign, whereas in the 4C category, 34 cases were malignant, and 10 were benign (P < 0.001).

Conclusion: This study demonstrated that VAB is an effective method for evaluating breast microcalcifications and can serve as a promising diagnostic tool for suspected cases.