Vacuum-Assisted Biopsy (VAB)

Vacuum-assisted biopsy is a minimally invasive way to remove small samples of breast tissue so they can be examined under a microscope. Unlike a standard needle biopsy, it uses gentle suction to draw tissue into the needle, which allows several samples, or a larger amount of tissue, to be collected through a single tiny skin opening. This makes it especially useful for sampling microcalcifications and small areas of concern that need a generous tissue sample for an accurate diagnosis. In some situations it is also used to completely remove certain small benign growths. The procedure is always guided by imaging — most often mammography or ultrasound, and occasionally MRI — so that the correct area is targeted precisely.

Before the biopsy, it is important to mention any blood-thinning medications, as these may need to be paused for a short time to reduce the risk of bleeding. The procedure is performed using local anesthetic, so eating and drinking are usually allowed beforehand. Because some people feel anxious, it can be helpful to arrange for someone to accompany them home, although most are able to drive themselves.

The skin over the area is cleaned and numbed with a local anesthetic, and a very small nick is made in the skin. Using imaging for guidance, the biopsy device is positioned at the target area, and suction draws tissue into the needle while several samples are collected. A tiny clip or marker is usually placed at the biopsy site so that the exact location can be identified on future imaging; this marker is harmless and stays in place permanently. The procedure typically takes between thirty minutes and an hour, and because only a small skin opening is needed, stitches are usually unnecessary and scarring is minimal.

Vacuum-assisted biopsy is generally very safe. The most common effects are bruising, mild tenderness, and a small amount of bleeding at the site, all of which usually settle within a few days. Infection is uncommon, and a larger collection of blood under the skin occurs only rarely. Applying ice and avoiding strenuous activity for a day or two helps recovery.

The pathology results are usually available within a few days. If the tissue is benign, the placed marker simply helps with future imaging comparison, and routine follow-up continues. If cancer or a high-risk change is found, the marker also helps the surgical team locate the area, and the care team will discuss the appropriate next steps in treatment.