Vacuum Assisted Core Biopsy of the Breast (VACB)

The doctor has recommended that you have a vacuum assisted core biopsy of the breast (VACB) because your mammogram (breast x-ray) has shown an abnormality. The majority of abnormalities are benign (innocent) and present no health risk to the patient, but it is important that we find out exactly what the abnormality is in your case. 

The VACB is a simple and quick method of taking samples of breast tissue which can be sent to the Pathology department to be examined under a microscope and provide your doctor with a diagnosis. There is no special preparation needed before having a VACB.

The VACB can be carried out using either x-rays or ultrasound depending on the position of the abnormality in your breast. The doctor will discuss this with you to decide the best method in your case and you will be asked to sign a consent form for the procedure. 

X-ray guided VACB 

The biopsy will be carried out by either a Breast Radiologist, a doctor who specialises in x rays, or an Advanced Radiographic Practitioner, a radiographer who has been specially trained in breast biopsies.  Depending on the area of the breast the sample is to be taken from you will either lie on a couch or sit up and your breast will be positioned in the x ray machine. 

Your breast will be compressed as it was for your mammogram examination and the staff will take x-rays to check you are in the right position. When you are in the correct position two x-rays will be taken at different angles, these are called “stereo images” and are used with the computer to find the exact position for the biopsy needle. 

You will be given an injection of local anaesthetic to numb the area to be biopsied. This will sting initially but after that you should not feel any pain. 

The procedure uses a vacuum system to remove the samples and you will be able to hear a noise a bit like a hairdryer while the samples are taken. 

Ultrasound guided VACB

The biopsy will be carried out by a breast radiologist or specialist radiographer and you will be asked to lie on your back on an examination couch. Your breast will be examined using the ultrasound machine to pinpoint the area that will be biopsied. You will be given an injection of local anaesthetic to numb the area and the vacuum assisted biopsy machine will be used to remove some samples of breast tissue.

X-ray guided VACB and Ultrasound guided VACB:

Sometimes a tiny metallic marker is placed in the breast to mark the area where the biopsy was taken. The staff will inform you if this is going to happen, you will not be able to feel the marker and it will not affect you in any way in the future.

When the test is finished the nurse will apply pressure to the biopsy site for ten minutes to reduce bleeding and bruising. She will apply some paper stitches and a dressing then you will be asked to get dressed and sit in the waiting area for a further ten minutes with a drink to ensure you feel well and there is no further bleeding before you go home.  

Most patients find lying on the couch quite comfortable, but you must let staff know if you have any problems with the position so that they can make adjustments to help you. 

The procedure should not be painful. There will be some stinging when the local anaesthetic is first injected but after this the area will become numb. You will feel some pressure on your breast as the biopsy is taken and staff will check regularly that you are comfortable and not feeling pain.

Most women feel fine after the procedure and are able to resume light activities. However we would recommend that you avoid strenuous exercise for at least 24 hours following the biopsy. If possible it is best to go home and put your feet up and relax for at least a few hours after the procedure.  

You must let staff know if you are taking a blood thinning medication such as warfarin or clopidogrel or if you are taking daily aspirin. In these circumstances you will be advised by the doctor of the correct preparation before you are given an appointment for this procedure.

What alternative procedures are available?

Wide core needle breast biopsy – This is a similar procedure to a VACB but a smaller piece of tissue is removed which may not be large enough for the laboratory to examine fully.

Diagnostic open biopsy – this is performed in theatre under general anaesthetic and would result in significant scarring of the breast and a short stay in hospital.

Your doctor will discuss with you which procedure is best for you.

What will happen after the procedure?

This is a simple procedure and there are no known serious risks or complications associated with it. Occasionally the tissue sample does not provide a diagnosis. For example it may not contain any of the tissue that the doctor wants to look at, there may not be enough breast tissue to test, or the results of the laboratory tests may be uncertain. 

If this is the case the doctor will discuss the options available to you. 

After this test you will probably have some bruising on your breast in the area the biopsy was taken from and sometimes a small lump may appear under the skin, this is nothing to be concerned about and should fade in a few days. If the area becomes red or inflamed or you are concerned please contact the department on the number provided in this leaflet. 

You may bathe or shower as usual and can remove the dressing after 24 hours. The paper stitches should be left on for approximately three days after which you may find it easiest to soak them off in the bath or shower.

If you feel any discomfort after the biopsy you can take paracetamol, unless you have a known allergy to this medication. Wearing a firm supportive bra may also help. 

How will I get my results?

This will depend on how you were referred for your breast biopsy.

You may be given an appointment before you leave the hospital to return to the breast clinic for your results or you may have an appointment sent in the post to see your consultant for the results.

Please feel free to ask staff if you have any concerns about how you will receive the results of your biopsy.

Further information 

If you have questions that are not addressed in this leaflet please contact Gateshead Breast Screening Unit, where staff will be happy to help you. 

0191 4453747 Monday to Friday 9 am to 5 pm 

Out of hours please contact NHS 111 

If you wish to give any feedback please contact the Superintendent Radiographer on 

Tel: 0191 4453775

Data Protection

Any personal information is kept confidential. There may be occasions where your information needs to be shared with other care professionals to ensure you receive the best care possible.

In order to assist us to improve the services available, your information may be used for clinical audit, research, teaching and anonymised for National NHS Reviews and Statistics.  

Further information is available via Gateshead Health NHS Foundation Trust website or by contacting the Data Protection Officer by telephone on 0191 445 8418 or by email [email protected].