Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
Vacuum-assisted breast biopsy is a tissue sampling technique that uses a special instrument and imaging guidance to remove samples of breast tissue through a single, small skin incision. This technique allows the surgeon to remove more tissue through a single incision than is possible with a traditional core biopsy and is a much less invasive procedure than an open surgical biopsy. For these reasons, vacuum-assisted breast biopsy is becoming more common as a diagnostic tool in the management of breast lumps and abnormalities.
Different systems for performing the vacuum-assisted biopsy have been developed by different companies, but all involve the placement of a biopsy probe using radiology imaging studies for guidance. Mammograms taken from different angles (stereotactic mammography), ultrasound, and MRI have all been successfully used to identify the abnormal areas to be sampled by vacuum-assisted breast biopsy. Once the biopsy probe has been positioned, a vacuum pulls the breast tissue through an opening in the probe into the sampling chamber of the device. Then a rotating cutting device in the instrument removes the tissue sample, which is carried through the biopsy probe to a tissue collection receptacle.
The physician then turns a control knob on the biopsy probe that moves the sampling chamber to a new position. This procedure is repeated until all desired areas have been sampled. In this way, samples can be taken all around a suspicious area through a single insertion of the biopsy probe. With a traditional core biopsy, sampling of multiple areas would involve repeated insertions of the biopsy instrument.
The vacuum-assisted biopsy technique is performed under local anesthesia and leaves a small incision that does not require stitches for closure. It takes less than an hour to perform, and patients can usually return to normal activities soon after the procedure. It provides the ability to retrieve larger amounts of tissue for diagnosis without the costs and discomforts of an open surgical biopsy.
Not all breast abnormalities can be sampled using the vacuum-assisted technique, since some conditions of the breast may make the areas of interest difficult to locate using imaging techniques. The procedure must be performed by a surgeon or radiologist who has experience with the procedure.