Vacuum Assisted Excision (VAE) of breast tissue

This is a procedure where either a mammogram (breast X-ray) or an ultrasound scan is used to help find a specific area in the breast.
A small sample of tissue is also taken from the breast using a special vacuum needle.

Your recent biopsy found some abnormal cells in your breast.
These are benign (non-cancerous) changes, but they need to be removed because they may be an early sign of changes happening in that area of breast tissue.
In the past, these would have been removed with surgery under a general anaesthetic (where you are asleep).
New technology now means they can be removed using a local anaesthetic (where the area is numbed) in the breast imaging department.

The procedure will be done in a mammogram or ultrasound room, depending on where your earlier biopsy was done.
You will be awake during the whole test. It usually takes about 45 minutes.
A specially trained doctor (Radiologist) or Advanced Practitioner will carry it out.
You will be asked to take off your clothes from the waist up and put on a hospital gown.
A Radiographer will help position you, either sitting or lying down on a couch, depending on where the area in your breast is.
Images will be taken to check that the right area has been found.
A local anaesthetic (numbing medicine) will then be used to numb that part of the breast.
A special vacuum needle is used, which gently sucks out a sample of tissue. This helps take a larger sample than the first biopsy.
After all the samples are taken, a very small metal (titanium) clip will be placed into the breast through the biopsy needle.
This marks the exact area where the samples were taken.
This should be a painless procedure.
The marker is harmless. It will stay in the breast and cause no discomfort.
It is necessary because it marks the area of concern and can be easily seen on future mammograms.

Complications from VAE are rare.
However, as with any procedure there are some risks associated with it. They include:

Internal bruising (haematoma) in the breast following the procedure

We try to reduce bruising inside the breast by pressing firmly on the area straight after the biopsy.

Bleeding from the wound site

Infection of the wound site

Inconclusive biopsy result

There is a small risk that the abnormal area is in a part of the breast where it is difficult, or not possible, to take good tissue samples.
This may mean the biopsy does not give a clear result.
The doctor may suggest another test instead, such as a diagnostic excision biopsy, which is explained in the next section called �Are there any alternatives?�.

An alternative to VAE biopsy is a diagnostic excision biopsy.
An excision biopsy is an operation done in the operating theatre while you are asleep (under a general anaesthetic).
During this surgery, the Surgeon removes the area of abnormal tissue from the breast.
As well as removing the abnormal area, the Surgeon also removes a small border of healthy breast tissue around it. This is called a �margin�.
Excision biopsy leaves a scar and needs more time to recover.

You can eat and drink normally before and after the procedure.
Medicines: Please tell your Doctor about any medicines that you are taking.
Especially if you are taking any antiplatelet medicines (for example aspirin or clopidogrel) or anticoagulant medicines (for example warfarin or rivaroxaban).
Please tell the team if you have ever had heavy or difficult-to-control bleeding, or if you are allergic to any medicines.
Please call the Imaging Help Desk on 020 7288 5888 and ask to speak to the Breast Imaging Team if you have a disability, find stairs difficult, or are (or might be) pregnant.

If you have any further questions, or would like to change your appointment, please contact the Imaging Help Desk.

Tel.: 020 7288 5888, Monday to Friday 9am to 3pm.

Published:

25 Jun 2026

Review:

25 Jun 2028

Reference:

ACW/Imag/VAEB/01