Vacuum assisted biopsy

A vacuum assisted biopsy (VAB) of the breast is a way of taking a sample of abnormal breast tissue to look at under the microscope.

The test is also called:

  • a mammotome biopsy
  • a minimally invasive breast biopsy (MIBB)
  • a vacuum core biopsy

You might have this test if your doctor sees an abnormal area in your breast on a mammogram or ultrasound scan.

How you have it

A doctor uses a special needle attached to a vacuum device to remove the breast tissue. The samples are examined under a microscope. This can show whether there is a cancer or another type of breast condition. 

You have this under imaging guidance. This means the doctor uses either a mammogram or ultrasound scan to find the exact area they will biopsy.

You might have this test in the radiology department or special breast imaging department of the hospital.

Preparing for your vacuum assisted biopsy

You are able to eat and drink normally before your biopsy. Take your medicines as normal. But if you are taking any blood thinning medicines you might need to stop them before the test. Your doctor or nurse will tell you when to stop.

You have your biopsy under local anaesthetic. This means you are awake, but the area is numb.

Your doctor or nurse will give you information about the procedure and ask you to sign a consent form. This is a good time to ask any questions that you have.

What happens?

The test can take about an hour. Part of this time is making sure you understand the procedure and you are comfortable. A staff member will ask you to take off your upper clothing. You might put on a hospital gown.

In the examination room, you either sit or lie down. You might lie on your front on a couch or sit in a chair if the doctor is using a mammogram to guide the procedure. You usually lie on you back if the doctor uses an ultrasound scan. Your nurse or doctor will give you more information about how you have this.  

When you are comfortable you have either a mammogram or breast ultrasound scan to find the abnormal area. You need to stay completely still and not change your position. 

The doctor cleans the breast area. They use a local anaesthetic to numb the skin, which might sting a little. When the area is numb, they make a very small cut in the skin. Next, they put a hollow needle with a vacuum suction through the cut. You usually have another mammogram or ultrasound scan to check the position of the needle. 

Once in position, the needle stays in your breast while they take the samples. The doctor moves the needle to remove abnormal tissue from the area. The biopsy device makes various noises and you will feel it vibrating. This test isn't usually painful but you might have some discomfort for a short time. Tell the doctor if you find it painful. 

After the biopsy you might have another mammogram or ultrasound scan. The radiologist might put a tiny metal clip into the biopsy area if all the abnormal area is removed. The clip remains in your breast and will not cause you any harm. It is seen on all your future breast ultrasound scans or mammograms. This means that the area is easily found again if needed.  

The clip is made of titanium and doesn't cause any problems. It can safely stay in the breast tissue.

The doctor or a nurse puts pressure on your breast for 5 to 10 minutes after the test. This is to try to prevent bleeding or bruising.

You have a dressing put over the site, this is usually a paper stitch with a waterproof dressing. Or you may have a pressure dressing if there is a risk that the biopsy site may bleed. Your nurse will show how to look after this.

After your vacuum biopsy

You might need to stay for a little while in the clinic to make sure you feel well enough to travel home. Then you can get dressed and go home. But try not to do too much for the rest of the day. You should be able to go back to work the following day.

Try to avoid heavy lifting for 48 hours after this type of biopsy. This will help reduce possible risks. 

You can take paracetamol if your breast is sore or tender. Wearing a non wired soft bra may be more comfortable.

Your nurse will tell you how to look after the biopsy area and your dressing. You can have a shower or bath as normal if you have a waterproof dressing.

You might see some bruising in the area and this is normal. It will go after a week or two.

Getting your results

You should get your results within 1 or 2 weeks at a follow up appointment. 

Waiting for test results can be a very worrying time. You might have contact details for a specialist nurse who you can contact for information if you need to. It can help to talk to a close friend or relative about how you feel.

You can also contact the Cancer Research UK nurses on freephone 0808 800 4040 for information and support. The lines are open from 9am to 5pm, Monday to Friday.

Contact the doctor who arranged the test if you haven’t heard anything after a couple of weeks.

Possible risks

A vacuum assisted biopsy is a very safe procedure but your nurse will tell you who to contact if you have any problems after your test. Your doctors will make sure the benefits of having a vacuum assisted biopsy outweigh these possible risks.

Bleeding

It’s rare to have any bleeding after your needle biopsy. Your doctor or nurse will give you advice on what to do if you have any bleeding.

Swelling

Some people have swelling but this is rare. Let your healthcare team know if the area is swollen or very painful.

Infection

Your doctor or nurse will let you know how to look after your biopsy site, to keep it clean and dry. Contact your healthcare team if the area becomes increasingly red or hot, or you have increasing pain, rather than the discomfort or pain getting gradually better .

Last reviewed: 
22 Sep 2020
Next review due: 
22 Sep 2023
  • Early and locally advanced breast cancer: diagnosis and treatment
    National Institute for Health and Care Excellence (NICE), June 2018

  • Early Breast Cancer: ESMO Clinical Practice Guidelines
    F Cardoso and others 
    Annals of oncology, 2019. Volume 30, Pages 1194-1220

  • Clinical guidance for breast cancer screening assessment, Fourth edition
    NHS Breast Screening Programme, November 2016