Diagnostic vacuum breast biopsy

About the biopsy

When you have an area of change we cannot see on ultrasound we will need to use the mammography machine to guide in a special needle. The procedure is called ‘diagnostic vacuum breast biopsy under x-ray guidance’.

What is a vacuum biopsy?

After an injection of local anaesthetic, a hollow probe connected to a vacuum device is inserted through a small hole in the skin. Using a mammogram as a guide, breast tissue is sucked through the probe by the vacuum into a collecting chamber.

During this procedure you will lie on your side or sit at a special x-ray table with your breast compressed as for a mammogram. We will take a number of low-dose x-rays to help guide and confirm the correct needle position. The clinician and radiographers will explain what they are doing as they go along. You will need to keep as still as possible in order for us to take accurate samples of the area.

The needle is only in the breast for a few minutes but the whole procedure can take more than half an hour.

Anticoagulants or disorders of bleeding/ clotting

Some medicines that thin the blood such as warfarin, rivaroxaban or clopidogrel can make a biopsy difficult. If you are taking these sorts of tablets please phone the specialist breast care nursing team on 01223 586960 to discuss this.

Who will perform my procedure?

This will be done, or be very closely supervised, by an expert clinician in the field.

Will the procedure hurt?

The compression might be uncomfortable and the local anaesthetic might sting for a few seconds until it takes effect. Most patients report that this procedure is straightforward and tolerated well.

How much breast tissue will be removed?

We will remove several small pieces of breast tissue to be sure we have enough for an accurate diagnosis. If you have an area of calcification we x-ray the samples using a separate machine to check that we have successfully removed some of the specks of calcification. If we have not obtained enough calcification we will talk to you about taking more tissue.

What if all of the area of concern is removed?

We insert a titanium marker clip into the biopsied area after taking all the samples. This is in case we need to find this area again later. This marker can remain in your breast without causing future problems, for example with subsequent MRI (magnetic resonance imaging) scans or metal detector systems.

After the procedure

The team who perform the biopsy will see you before you go home. You will be able to discuss any questions or concerns. The final answer will not be available until the specimen has been examined in the laboratory.

You may eat and drink as normal following this procedure. You can leave hospital shortly after the procedure once this has been agreed by the team treating you. Usually, you can resume normal activities immediately following the procedure. Although it might be best to avoid going to the gym or heavy lifting for the next 48 hours.

A small dressing will be applied to your breast. Ideally, the gauze should be kept dry and can be removed after 24 hours. It is safe to shower and bath with the skin closures which you should keep in place for a further three or four days.

If you experience any pain and/or discomfort, we advise that you take a mild pain killer such as paracetamol. Avoid aspirin as this could encourage bleeding.

Are there any side effects?

This is a very safe procedure. The commonest side effect is some bruising or bleeding around the area. We try to reduce this by applying some hand pressure at the time. If the wound starts to bleed again, apply firm pressure for several minutes. More severe side effects or problems such as infection are extremely rare.

When will I get the result?

We try to get the result of this test ready for you within ten days. You will be given an appointment before you leave us on the day of the procedure. This may be a telephone or face-to-face appointment.

Alternative procedures that are available

A surgical operation could be performed to remove the potentially abnormal area. However, this would leave a surgical scar, and it would necessitate a general anaesthetic and a day in hospital. To guide the surgeon to the correct site, a needle would still need to be placed in the breast before the operation. Alternatively, we could decide to actively monitor to see if this area changes or grows using regular mammography. We will discuss with you the implications of not having a biopsy.

Photography, audio or visual recordings

As a leading teaching hospital we take great pride in our research and staff training. We ask for your permission to use images and recordings for your diagnosis and treatment; they will form part of your medical record. We also ask for your permission to use these images for audit and in training medical and other healthcare staff and UK medical students. These images will be completely anonymised. You do not have to agree and if you prefer not to this will not affect the care and treatment we provide. We will ask for your separate written permission to use any images or recordings in publications or research.

Students in training

Training doctors and other healthcare professionals is essential to the NHS. Your treatment may provide an important opportunity for such training, where necessary under the careful supervision of a registered professional. You may, however, prefer not to take part in the formal training of medical and other students without this affecting your care and treatment.

Use of tissue

As a leading biomedical research centre and teaching hospital, we may be able to use tissue not needed for your treatment or diagnosis to carry out research, for quality control or to train medical staff for the future. Any such research, or storage or disposal of tissue, will be carried out in accordance with ethical, legal and professional standards. In order to carry out such research we need your consent. Any research will only be carried out if it has received ethical approval from a research ethics committee. You do not have to agree and if you prefer not to, this will not in any way affect the care and treatment we provide.

The leaflet ‘Donating tissue or cells for research’ gives more detailed information. Please ask for a copy.

If you wish to withdraw your consent on the use of tissue (including blood) for research, please contact our Patient Advice and Liaison Service (PALS), on 01223 216756.

Information and support

The breast care nursing team is available to answer any questions after your biopsy and while you are waiting for your results. After the biopsy you will meet one of the team who will give you their card with contact details.

There are no national leaflets specifically about needle biopsy, but the Breast Cancer Care website (opens in a new tab) is easy to use, and has lots of general information.