• Reference Number: HEY-757/2023
• Departments: Breast Services
• Last Updated: 3 April 2023

Introduction

This leaflet has been produced to give you general information about your procedure.  Most of your questions should be answered by this leaflet. This is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.  If, after reading this leaflet, you have any concerns or require further explanation, please discuss this with a member of the team caring for you.

What is a Vacuum Assisted Biopsy?

A vacuum assisted biopsy (VAB) is a biopsy under local anaesthesia, similar to a core biopsy (which takes a small amount of tissue under local anaesthetic). The VAB uses a special instrument which utilises vacuum or suction and therefore enables more tissue to be removed. This gives more information about the abnormality in your breast tissue.  A vacuum assisted biopsy (VAB) can be done using either ultrasound or X-ray guidance.

Can there be any complications or risks?

Following a VAB you may experience the following problems:

• Your breast may be discoloured with bruising
• You may have swelling in the area
• You may experience discomfort

A comfortable supportive bra and pain relief such as paracetamol may help.  Please avoid taking any tablets containing aspirin as this can cause more bruising.  On rare occasions your wound may bleed, if this happens, sit down and press firmly on the dressing until the bleeding stops.  If the bleeding continues but is light, call the Breast Ward at Castle Hill Hospital on (01482) 622644 to seek further advice.  However if the bleeding is severe, please seek emergency assistance by dialing 999.

All potential complications or risks will be discussed fully with you by a member of the healthcare team.  Please ask if you need clarification.

How do I prepare for the procedure?

Medication

Please let us know if you are on medication to thin your blood, such as warfarin, aspirin or Clopidogrel, by telephoning the department on (01482) 622644

Upon Arrival

Please come to the reception desk within the Breast Unit, Castle Hill Hospital access via entrance 1. You will be called into the breast X-ray / ultrasound room by an imaging support worker and the consultant who will be performing the procedure.  They will explain what will happen and gain your consent.  You may be in this room for up to one hour.

Before the Procedure

If we are using ultrasound to locate the area for biopsy, you will be asked to lie on your back. If the procedure is being done using X ray guidance, you will be asked to lie on your side or occasionally the procedure will be done while you are sat up in a special chair. We will ensure you are comfortable before the procedure begins.

During the Procedure

When you are in the correct position and are comfortable, a local anaesthetic will be injected into the skin and into the breast tissue to numb the area.  When this is numb (after a few seconds) we will make a small cut in the skin to take the biopsy.  The biopsy is taken using suction and you will hear a noise in the background while the procedure is in progress.

We will remove several small pieces of tissue and may X-ray these while you are having the biopsy done.  When the biopsy is performed, a tiny marker clip may be left in the breast tissue so that this area can be seen on your future mammograms.  This marker is perfectly safe and made of titanium (the same metal many artificial joints are made of).

Driving Upon Discharge

Do not drive for 24 hours following the procedure, therefore you will need to make arrangements for someone to drive you home after your biopsy.

What happens afterwards?

Try to avoid any strenuous activity or lifting for at least 24 – 48 hours.  You may remove the pressure dressing the day after your biopsy.  Try to keep the dressing dry until you have removed the small dressing and adhesive strips after 4 days.  An appointment will be sent in the post when your results are available, which may take up to 2 – 3 weeks.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Breast Care Nurse Team (01482) 622013.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.