Vacuum Assisted Excision (VAE) of Breast

Vacuum Assisted Excision (VAE) of Breast

WHAT IS A VACUUM ASSISTED EXCISION?

A vacuum assisted excision (VAE) is a procedure undertaken under local anaesthetic and is obtained using either ultrasound or X-ray guidance.   The VAE uses a special needle attached to a vacuum device to enable more tissue to be removed.  This allows your doctors to make confident decisions on your treatment plan. 

WHY SHOULD I HAVE THIS PROCEDURE?

As you are aware your recent biopsy did not show any cancer cells. However, some benign lesions require removal because they can be a very early indication of changes in the breast tissue in that area. Previously these lesions required surgical removal under a general anaesthetic, new technology now allows us to remove these under local anaesthetic in the breast imaging unit.

HOW DO I PREPARE FOR THE PROCEDURE?

• Medication – Please let us know if you are taking any blood thinners, for example: warfarin, edoxaban, apixaban or rivaroxaban as you may need to stop them before the procedure. 
• Allergies – If you are allergic to any medication, but particularly local anaesthetic please contact us when you receive your appointment letter
• Deodorant – On the day of your appointment please do not wear spray deodorant, powder lotion or perfume on the breast and underarm area as these may show on the mammogram films.
• Meals – You can eat and drink as normal prior to the procedure.
• Escort – If possible, please bring a friend or relative to accompany you home, please note they will not be allowed into the examination room. 

WHAT HAPPENS DURING THE PROCEDURE?

Before the procedure begins our staff will discuss the procedure with you and ask you to sign a consent form.

If we are using the x-ray machine to guide us a Radiographer will position you in the mammogram machine, either sitting or lying down.  Mammogram images will be taken to check the correct area has been located. 

Under aseptic control, a local anaesthetic will be injected into the skin and into the breast tissue to numb the area.  When this is numb, a Radiologist or Specialist Radiographer will make a small cut in the skin, and the needle will be inserted into the breast.  You may have more x-rays to check the needle position. 

A vacuum system is then used to remove the breast tissue sample; you will hear a noise in the background and feel some vibration while the procedure is in process.

Once all the samples have been taken a tiny marker clip may be inserted into the breast tissue so the area can be seen on future mammograms.  This marker is perfectly safe; it is made of titanium and can safely be left in the breast tissue. 

The test takes about 45 minutes and isn’t usually painful, but you might have some discomfort for a short time. 

You will need to stay for at least one hour in the clinic following the procedure to ensure you feel comfortable to drive home.

We will discuss post procedure information with you following the examination.

If using ultrasound guidance, you will be lying on the couch in the ultrasound room. The procedure is the same as described above without the need for positioning in the x-ray machine.

WHAT ARE THE RISKS?

Complications from VAE biopsy are rare. However as with any procedures there are some risks associated with it, they include:

• Internal bruising (Haematoma)in the breast following the procedure and bleeding at the wound site can occur. We try to minimise internal bruising and bleeding by placing firm pressure on the breast immediately after the procedure. We will give you instructions on what to do if you notice some bleeding following the procedure.
• You may feel discomfort following the procedure when the local anaesthetic wears off, a mild pain killer may be taken.
• Infection is very unusual and may require antibiotics. The wound will be covered with a sterile dressing, and you will receive aftercare guidance. If the skin around the wound becomes red and sore you should consult your GP.
• There is a small chance that the area of abnormality is in a position that makes it difficult to collect enough samples. Occasionally, the procedure itself can also be challenging to complete. If this happens, the results may not give a clear answer, and further tests or procedures may be needed.

WHAT HAPPENS AFTER THE PROCEDURE?

Firm pressure is applied to reduce bruising and bleeding. Steri- strip plasters are used to close the small incision in the skin and a dressing applied. This should stay on for approximately 72 hours. During this time, please avoid strenuous activity such as lifting, heavy housework or sports. It may help to wear a sports bar for 24-48 hours. The anaesthetic will wear off after 2-3 hours, and you may feel the need to use a mild painkiller, avoiding aspirin as this may cause extra bruising.

The pain and discomfort should subside in a day or two. You will be left with a small permanent scar at the biopsy site. Rarely the site can bleed after you have gone home. If this happens apply firm pressure over the wound for 10 minutes. If the bleeding continues after this time, please either contact our breast nursing team on 01905 760261 (9am-5pm) or contact NHS 111 (after 5pm)

WHEN WILL I RECEIVE MY RESULTS?

The results will not be given to you immediately after the procedure. You will receive a letter within 3 weeks of the procedure to advise you on next steps.

CONTACT US AT:

Hereford and Worcester Breast Imaging

Worcester Breast Unit

Worcestershire Royal Hospital

Charles Hastings Way

Worcester

WR5 1DD

Tel: 01905 760145

Email:  [email protected]

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience

We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback

Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)

If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:

Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:

The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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