Tomosynthesis Vacuum Assisted Core Biopsy (VAB)

By using special attachments on the mammography equipment, Tomosynthesis Vacuum Assisted Core Biopsies (VAB) can be performed using guidance, and an aseptic technique (strict infection control practices).

The procedure is much the same as under ultrasound, but you will be sitting on a chair or lying on a special trolley while the procedure is done. A local anaesthetic is used, and the mammographers will make sure the procedure is as comfortable as possible.

These procedures are only done at our rooms at Burnside Hospital (Attunga Medical Centre) and St Andrew’s Hospital (MRI section).

This involves taking multiple samples of tissue (cells) through a needle. The needle is guided into place using x-ray.

A radiographer will position you for the procedure. Once the area is identified, the radiologist will clean your skin and then local anaesthetic will be injected. You may feel some pressure, but most women report no pain.

Multiple tissue samples will be taken, and there may be the need to place a small marker at the site of the biopsy for future reference. The marker is made of titanium and poses no health or safety risk. You will not be able to feel or notice the marker.

The sample is sent to a pathology laboratory where it is analysed. Results are usually available in 2 to 3 days. The report will be sent to your referring doctor who will then give these results to you. The pathology company may charge a gap for these services. Please discuss this with us if you have any questions.

A site marker is placed within the biopsy site while you are still in the mamography machine, so that the area may be identified by either mammogram or ultrasound for future reference, if any surgery is required. The site marker is made of either titanium or stainless steel; it is inert and safe to stay in your body. It does not ‘beep’ at airport security. Another mammogram will be done at the end of the procedure to confirm position of site marker.

Before your Scan

Please tell us if you are on medication to thin your blood (e.g. Warfarin, Aspirin or Clopidogrel). You may need to stop this medication before the procedure, but only after you have discussed it with your doctor.

It is important that you have someone to drive you home after the procedure.

Specific Requirements

It is essential that your previous mammogram and ultrasound films are available at the time of the biopsy. Please bring these with you to your examination.

Risks / Side effects

Potential risks include:

• Infection at the needle site. An aseptic technique (strict infection control practices) is used to minimise the risk of infection.
• Bleeding: mild bleeding in the area may cause it to swell, which should subside after a couple of days. The needle may puncture a blood vessel. Rarely, excessive bleeding can occur and may require drainage.
• Bruising: there may be some mild bruising at the site.
• The biopsy may not get an adequate sample of tissue which may require you to have a repeat biopsy.

Other Information

• Steri-strips and a waterproof dressing will cover the incision.
• The outer dressing should remain in place for at least 24 hours; the steri-strips are left to gradually lift off after a few days.
• You will be given an ice-pack to use to reduce bleeding and discomfort.
• You can eat and drink immediately after the procedure.
• Avoid strenuous activity for 24 hours following the biopsy.
• You may experience some discomfort following the procedure. A simple analgesic such as paracetamol (Panadol) should provide some relief if needed. Do NOT take Aspirin.
• A small ice-pack applied to the area may help settle the pain.
• Bleeding and infection are potential complications. If you notice any increased redness, swelling, fever or pain, notify your referring doctor or immediately call the clinic where the injection was performed.

If you have not been contacted about your results in 1 to 2 weeks, please contact your referrer.