Vacuum-Assisted Biopsy (VAB)

What is a vacuum-assisted biopsy (VAB)?

A vacuum-assisted biopsy (VAB) is a procedure that takes multiple samples of tissue from an area of abnormality for testing.

It is the most common alternative procedure to traditional core biopsy in managing suspicious breast lesions, as it allows multiple cores of tissue to be removed with a single insertion.

How it works

The area of abnormality within the breast is precisely located using either an ultrasound or mammogram. A small 5mm incision is then made to collect tissue samples from the suspicious area of the breast. Mammotome and SenoRx are the two most commonly used devices for VAB.

Why do you need a vacuum-assisted biopsy (VAB)?

There are tiny masses in your breast that can only be detected by a mammogram. If your doctor notices something suspicious from your mammogram, breast ultrasound or MRI results, you may need a breast biopsy to check for malignancy. A biopsy is used to diagnose or rule out breast cancer.

Your doctor may recommend a VAB because it is safe compared to other tissue sampling techniques.

What are the risks and complications of a vacuum-assisted biopsy (VAB)?

During the biopsy, you may experience mild discomfort. Significant bleeding or pain during the biopsy is rare.

After the biopsy, you may experience:

• Bruising
• Discomfort
• Tenderness
• Mild bleeding at the biopsy site, though occasionally bleeding is significant

Other rare post-biopsy complications include:

• Breast infection
• Allergic reaction to the local anaesthetic

Complications from a breast biopsy can delay subsequent breast surgery.

Learn more about breast biopsy procedures (including VAB) in this comprehensive guide.

How do you prepare for a vacuum-assisted biopsy (VAB)?

You may eat a light meal before the procedure if it will be done under local anaesthesia.

You should:

• Wear a loose-fitting garment that can be easily removed during the test.
• Avoid using talcum powder under your arm as it may cause problems with the imaging studies.

Note: Let your doctor know if you are taking any blood-thinning medications or aspirin so that your doctor can assess if it is safe for you to undergo the procedure.

What can you expect in a vacuum-assisted biopsy (VAB)?

VAB is a minimally invasive breast biopsy procedure that causes minimal pain and scarring. It can be done in an outpatient setting in a doctor’s office under local anaesthesia, or as a day surgery procedure under sedation.

Estimated duration

The entire procedure generally takes less than an hour.

During the procedure

Your breast will be cleaned, and local anaesthesia will be given to numb it. With the assistance of a mammogram unit or ultrasound, your surgeon will insert a probe into the suspicious part of your breast.

Once the probe is in place, a rotating cutting device will remove a tissue sample and carry it through the probe into a tissue collection area.

This process may repeat several times until all suspicious areas are sampled to determine whether there is cancer or other conditions. Your surgeon will examine your sample tissue under a microscope.

If the tissues are benign, you do not need to undergo further surgery. If the tissues are malignant, your surgeon will insert a clip after removing the lump. This clip will be used to mark the location of the biopsy should further surgery be required.

After the procedure

You should be able to return to normal daily activity afterwards. The results of your breast biopsy should be ready in 3 – 5 days.

Care and recovery after a vacuum-assisted biopsy (VAB)

You can expect some swelling and bruising. This should resolve in about 1 – 2 weeks. During this period, you should:

• Apply a cold pack to the biopsy site every 1 – 2 hours to relieve the temporary bruise and inflammation.
• Take non-aspirin oral pain relievers containing acetaminophen to ease your pain, which may manifest as breast tenderness.
• Refrain from strenuous activity.

Let your doctor know if you experience any significant breast swelling, bruising or redness at the biopsy site.