Background: Current epidemiologic statistics indicate that a woman has a 1in 8 chance of having breast cancer in her life time. However ,benign breastdisease will develop in significantly more women during their adult lives ,withestimates that 60% of all women will experience this condition. The traditionaltreatment aimed at symptomatic relief and confirmation of the lesion’s natureis through open surgical excision and biopsy, but patient’s would still faceundergoing open surgery for the relief of symptoms. A third option is nowavailable –that of percutaneous vacuum-assisted excision under localanesthetic performed in a similar fashion to conventional percutaneous needlebiopsy. Purpose: This study was designed to evaluate the vacuum assistedhandheld device(the mammotome) as a closed method for percutaneousultrasound guided removal of breast masses under local anesthesia. Patientsand Methods : Fifty Consecutive patients with benign and suspicious lesionsradiologically classified as BIRADS 2,3&4 underwent percutaneousultrasonographic guided removal of evidence based image of the lesion underlocal anesthesia. All study procedures were performed following theinternational review board guidelines for protection of human subjects. Thetissue samples were sent for histopathology. Patients were followed one week,one month and 6 months after the procedure .Patient tolerance ,patientsatisfaction and the ability of the procedure to eliminate a palpable findingwere evaluated and findings at follow up ultrasound visits were recorded.Results: The biopsy procedure was completed in all cases,40 cases ( 80% )were proved benign and 9 cases ( 18% ) were malignant & 1 case ( 2% )was histopathologically diagnosed as atypical lobular hyperplasia. After VAB10 cases( 20% ) on basis of their histopathological diagnosis ; atypical lobularhyperplasia (n=1),duct carcinoma(n=5),DCIS (n=3) & intraductal papillarycarcinoma (n=1) were surgically managed. Complete removal of image basesevidence of a lesion (ranging in sizes between 0.7-2.8cm) occurred in 80% ofcases(n=40) .Incomplete removal occurred in 20% of cases(n=10).Among theremoved benign lesions ,fibroadenoma was the most commonly encounteredbenign tumor ,it was the diagnosis in 36% of cases(n=18).Fibroadenolipomaoccurred in 10% (n=5),lipoma occurred in 4%(n=2),focal fibroadenosisoccurred in 4%(n=2), sclerosing adenosis occurred in 8%(n=4),fibrocysticdisease occurred in 10% (n=5), & intraductal papilloma occurred in 8%(n=4).Conclusion :The VAB using the mammotome is a fast ,simple, cost-effective ,sutureless alternative without general anesthesia to open surgical breastbiopsy .It can be a reliable option for treatment of benign breast tumorsproviding a quicker ecovery and better cosmetic outcome than the traditionalsurgical excision