Therapeutic vacuum breast excision

About the procedure

The results of your recent needle biopsy showed that you had an area of abnormal cells/ tissue in your breast. We would like to take more breast tissue to be certain of the diagnosis. Most of the time we find no further changes or just more of the same tissue. In about one in six of women we find a cancer.

In the past we used to do this as a surgical operation under general anaesthetic, now we can perform this using a vacuum needle and obtain the same results.

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 mammography or ultrasound as a guide, breast tissue is sucked through the probe by the vacuum into a collecting chamber. The biopsy device is used until as much of or all of area being investigated has been removed.

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

It is likely that we will also remove the original marker if one was placed at the time of your initial biopsy so a second one will be placed so that the area can be identified in the future if needed.

Alternative procedures that are available

A surgical operation could be performed to remove the 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 the implications of not taking any further tissue with you.

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 or similar medication, please phone the clinical nurse specialist team on 01223 586960 to discuss.

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 local anaesthetic might sting for a few seconds until it takes effect. Most patients report that this procedure is straightforward and tolerated well. If we perform this under x-ray (mammography) guidance the compression might be uncomfortable.

After the procedure

The team who perform the procedure will talk to 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.

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 health 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.