Vacuum Assisted Excision (VAE) of the Breast

Vacuum Assisted Excision (VAE) of the Breast

Patient Information

Breast Screening

Author ID:           GE

Leaflet Ref:         BSC 005

Version:              1

Leaflet title:         Vacuum Assisted Excision (VAE) of the Breast

Date Produced:   August 2025

Expiry Date:        August 2027

Introduction

This leaflet provides you with information about a vacuum assisted breast excision (VAE), including the benefits, risks, the appropriate aftercare and what you can expect to happen at your appointment. 

If you have any further questions or concerns, please ask to speak to an Advanced Practitioner Radiographer within the Breast Imaging Unit on Telephone: 0300 707 5899, or a Breast Care Nurse on Telephone: 0300 707 5720 (9am to 4pm, Monday to Friday).

What is a VAE?

A VAE is a non-surgical procedure, in which ultrasound or mammogram equipment is used to help locate an area of interest within the breast and to take tissue samples of the area of interest that are larger than for a standard breast biopsy. 

Benefits

• More tissue can be sampled of the area of abnormality, which can be examined in greater detail 
• A VAE is less invasive than surgical excision of the lesion, and general anaesthetic is not required
• There is less scarring than a surgical procedure

Preparing for the procedure

• You can eat and drink normally before and after the procedure
• If you are taking any antiplatelet medicines (for example aspirin or clopidogrel), or anticoagulant medicines (for example warfarin or rivaroxaban), please let the team know
• Please arrange time off work on the day of the procedure. You may require additional time off after the procedure, but this is dependent on discomfort and bruising, which may be different for each patient

What happens during the procedure?

• The procedure will take approximately 45 minutes to complete
• You will be seen by a Consultant Breast Radiologist, who will explain the procedure and ask you to sign a consent form
• The procedure will then be performed by a Radiologist or Advanced Practitioner Radiographer
• The procedure can be performed via Ultrasound or X-ray guidance. The imaging technique which best shows the area of interest will be used
• The procedure will be performed either sitting up or lying down, depending on where the area of abnormality is within the breast
• Local anaesthetic will be administered to numb the specific part of the breast
• A needle will be inserted into the breast. Small samples of tissue will be taken. You will hear a noise from the machine whilst the machine is taking the samples
• Once the samples have been taken, a tiny metal marker clip will be inserted into the breast to mark the area where the samples were taken. The marker is harmless (it will stay in the breast and cause no discomfort), and is necessary because it marks the area of concern and can be easily seen on mammogram images

Risks

• Internal bruising (haematoma) in the breast following the procedure. To minimise internal bruising, firm pressure will be applied to the breast immediately after the procedure. However, it is likely that external bruising will appear. This may increase over the next few days, but this will settle and reduce over the next few weeks
• Bleeding from the wound site. In rare cases, the biopsy site can start to bleed after you have left the Unit. We will give you instructions on what to do if this happens
• Infection of the wound site. The wound will be covered with a sterile dressing after the procedure, and we will give you advice on how to look after the area
• The local anaesthetic will wear off after a few hours and you may feel some soreness. Paracetamol can be taken. Avoid taking aspirin, as this may cause extra bruising in the breast. 
• There is a small risk that the area of abnormality is in a part of the breast where it proves difficult to obtain a good tissue sample. In this case, the breast multi-disciplinary team will decide on how to proceed with obtaining a sample

What happens after the procedure?

• Firm pressure is applied to the breast to reduce bruising for approximately 10-15 minutes. This will help to minimise the risk of developing internal bruising in the breast (haematoma)
• Once pressure has been applied, the wound will be closed using wound closure strips (steri-strips™) and a sterile dressing will be applied. 
• Once you are dressed, we will make you a hot drink and allow you to sit for 30 minutes after the procedure, so we can ensure there is no further bleeding from the incision site.
• A mammogram will then be performed with minimal pressure, to ensure that the clip marker placed in your breast is in the right position 
• A Radiographer will then apply a pressure dressing to minimise the risk of any further bleeding. We advise this stays in place for 48 hours following the procedure 
• A results appointment will be made for you following the procedure 

What do I need to do after I go home?

• Over the next 3 days, try to avoid any strenuous activity such as exercise, heavy lifting or housework. This is essential to allow the breast to heal
• The anaesthetic will wear off approximately two to three hours following the procedure. If you then find your breast uncomfortable or painful, take mild pain relief such as paracetamol, following the instructions on the pack. Avoid taking aspirin, as this may cause extra bruising in the breast
• The dressings applied are waterproof, so you can bath or shower, but try not to soak the area. The waterproof dressing and wound closure strips should remain on for three days 
• In rare cases, the biopsy site can start to bleed after you have gone home. If this happens, apply pressure to the breast over the biopsy site for 10 minutes. If the bleeding continues, please continue to apply pressure, and contact the department on Telephone: 0300 7075720, (9am to 4pm, Monday to Friday). If the bleeding occurs out of hours, please attend your local Emergency Department.

How will I get the results of the VAE?

• The biopsy result will be discussed at a multidisciplinary meeting before results are given
• Before you leave the clinic, you will be given a date for an appointment where you will receive the results of the biopsy. This is usually within one to two weeks