Stereotactic Vacuum-Assisted Needle Biopsy of the Breast
Date issued: June 2026
Review date: June 2028
Leaflet section: Breast Care
PDF: Stereotactic Vacuum-Assisted Needle Biopsy of the Breast.pdf [pdf] 195KB
West Devon and East Cornwall Breast Screening Service
What is a stereotactic VAB of the breast?
A procedure where mammogram equipment is used to locate an area of interest in the breast, and a needle biopsy (tissue sample) is taken from the breast. The needle is attached to a vacuum device which uses gentle suction to sample breast tissue.
Before the day of the procedure
It is important to tell us if you take any blood-thinning medication (e.g., Warfarin, Aspirin, Clopidogrel, Rivaroxaban, Apixaban) or have any medical condition affecting your blood clotting.
Some blood-thinning medications will need to be temporarily stopped prior to the procedure if it is safe to do so, otherwise, the procedure will be cancelled, and another appointment will be arranged. You can contact the breast care nurses if you still have any queries about the need to stop any blood-thinning medication and when.
On the day of the procedure
Eat and drink as normal and take your usual medications before your appointment (unless we have specifically asked you not to take your usual blood-thinner). Bring a list of your medications with you. Wear a comfortable close-fitting bra as this will help support the dressing after the procedure. The test usually takes around 45 minutes, but please allow up to 2 hours for your entire visit.
What happens during the procedure?
You will be asked to undress to the waist and put on a hospital gown, and to remove shoes.
We will position you in the mammogram machine, usually lying face down on a special examination table with the breast positioned through a round hole. Mammogram images will be taken to find the area of interest. It is very important to keep the breast still once we have found the area, so we will ask you to not move your upper body, neck or shoulders once in position.
The skin of your breast will be cleaned with antiseptic. Local anaesthetic will then be injected into the breast. This can sting for a few seconds before going numb. Once numbed you should not feel anything painful, but you may be aware of dull sensations from your breast. A tiny cut is made in the skin and the biopsy needle inserted. When the biopsy is taken you may hear the whirring sound of the machine working.
Once the small samples have been taken, a tiny metal marker may be introduced into the breast through the biopsy needle. The marker is painless and is advised because it marks the area of concern. It can stay in the breast forever if your biopsy result is benign, and it will not cause any problems with MRI scanners or airport/other metal detectors. If the biopsy results show something which needs treatment, we can target that treatment correctly using the marker as a guide.
At the end of the procedure, we will press very firmly for around 15 minutes on the biopsied area with you lying on your back and then apply a dressing
What are the benefits of stereotactic VAB of the breast?
It is advised because it is not possible to tell what is causing the appearance in your breast using only examination or taking images. It is important to find out whether lesions in the breast are benign and can be left alone, or whether they are caused by something which may need treatment, such as a breast cancer. The VAB enables us to send a sample of this area to a Pathologist for analysis.
What are the risks of stereotactic VAB of the breast?
It is a very low risk procedure, but as with any medical procedure, there are some possible risks:
It is normal to have some bleeding from the biopsy site, this is usually minor and stopped by us pressing firmly on the biopsied area after the procedure. Very rarely, the surgeon may need to insert a superficial stitch. Rarely, the biopsy site can start to bleed again after you’ve gone home. If this happens, apply pressure to the breast over the biopsy site for 10 minutes in the same way as was done straight after the biopsy. If the bleeding continues after this time, please continue to apply pressure to the area and contact the breast care nurse number at the end of this leaflet within the hours of 9am and 4pm, or go to your local minor injuries’ unit or ED.
It is usual to have some bruising in the biopsied area. There may be aching or tenderness for a few days. Mild pain relief such as paracetamol may be helpful. Avoid taking aspirin (other than regularly prescribed aspirin) as this may cause extra bruising in the breast.
There is a small risk of infection in any procedure involving putting something through the skin (for this test less than 1/1000 risk of needing antibiotics). We minimise this by using a clean technique and sterile instruments for the procedure.
There is a small risk that we may not obtain enough tissue for diagnosis, and you may need a further biopsy to complete your assessment.
You may have a permanent tiny scar on the skin at the site of the biopsy.
After the procedure
You will be given advice about looking after the dressing on your breast. You should rest as much as possible for the remaining part of the day. Please avoid any strenuous activities, such as heavy lifting, running, or going to the gym for 24 hours following the procedure, but then you can return to your usual day-to-day activities. We will contact you when the results are available from the pathology laboratory and the situation will be discussed further during a clinic appointment. You can bring a relative or friend with you to the results appointment.
Can I refuse the biopsy?
Yes. Please talk about any worries you have with your consultant before making your decision. You can refuse the procedure or ask for the procedure to be stopped at any time.
Breast Care Nurses
If you have any concerns or require further information, please contact the breast care nurses on 01752 431898. Please leave a message with your name, date of birth and telephone number, and a nurse will get back to you. Calls are dealt with daily, Monday to Friday.
Other formats
If you need this leaflet in another format such as Braille, large print, high contrast, British Sign Language or translated into another language, contact the Patient Advice and Liaison Service (PALS):
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01752 439694
