Ultrasound Guided Vacuum-Assisted Excision (VAE) of the Breast
Date issued: June 2026
Review date: June 2028
Leaflet section: Breast Care
PDF: Ultrasound Guided Vacuum-Assisted Excision (VAE) of the Breast.pdf [pdf] 218KB
West Devon and East Cornwall Breast Screening Service
You have been advised to undergo a vacuum excision of an area in the breast. This area will have been previously biopsied and, based on this biopsy result, further tissue removal has been recommended to you. This will remove a larger sample of tissue to either (1) make a more confident diagnosis, or (2) remove a small lesion found on original biopsy.
What is a Vacuum Excision of the Breast?
This procedure removes an area of tissue inside the breast under local anaesthetic. It uses ultrasound-guidance like your previous biopsy but uses a larger needle with a suction attachment to take a larger sample, which is sent to the Pathologist for analysis.
Before the day of the procedure
Please 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.
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 30-45 minutes, but please allow up to 2.5 hours for your entire visit.
How is it done?
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The person performing the procedure will be either a Consultant Radiologist or Consultant Radiographer. In the room there will also be a Radiographer looking after the biopsy equipment and a Healthcare Assistant to take care of you.
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Local anaesthetic is given and, when the skin is numb, a very small cut is made, just big enough to put the needle into the area of interest in the breast. The needle is attached to a suction device.
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You may hear a sound similar to the whirring of a sewing machine, while the sample is drawn out by the vacuum suction device.
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When the sample has been taken, a tiny marker may be placed at the site through the biopsy needle. The marker is painless and is advised because it marks the area of concern. It can stay in your 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 area correctly using the marker as a guide.
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The needle will be removed and firm pressure applied to the biopsy site for at least 20 minutes to stop bleeding and reduce bruising.
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Dressings will be applied to the biopsy site. An information leaflet on aftercare of the biopsy site will be given to you.
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We ask you to remain in the department after the test for 30 minutes before you leave, in order that we can check that any bleeding has settled, and that you are feeling well enough to leave.
What are the benefits of Ultrasound VAE of the breast?
It helps us find out whether the area in your breast is benign and can be left alone, or whether there is something which may need treatment, such as a breast cancer, without the need for hospital admission or a general anaesthetic.
What are the risks of Ultrasound VAE of the breast?
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It is normal to have bleeding from the biopsy site; this is usually stopped by us pressing firmly on the biopsied area after the procedure. 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 in the same way as was done straight after the biopsy. If the bleeding continues after 10 minutes, 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.
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It is usual to have some bruising in the biopsied area. There may be aching or tenderness for several days. An internal bruise can cause a lump which can last for many weeks. The recovery time and degree of bruising is likely to be more than after your previous ultrasound needle biopsy.
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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).
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There is a small risk that the diagnosis may still not be established by this test, and further tests or surgery will be recommended to complete your assessment.
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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 72 hours following the procedure, but then you can return to your usual day-to-day activities.
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.
Results
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 may wish to bring a relative or friend with you.
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
