Objective To systematically summarize study-level factors associated with postoperative hematoma after ultrasound-guided vacuum-assisted breast lesion excision(VAE) using a vacuum-assisted breast biopsy (VABB) system, and to organize the available evidence according to a novel T-P-B framework comprising tumor-related, position-related, and breast- or peri-procedural management-related factors. Methods A systematic search was conducted in PubMed, China National Knowledge Infrastructure, Wan fang