Vacuum-assisted Breast Biopsy (VABB)
What is it?
Vacuum Assisted Biopsy (often called Mammotome, from the commercial name of the first handpiece used to perform it) is an advanced technique of breast needle biopsy for histological sampling of larger amounts of material than normal needle biopsy.
This system allows a larger amount of breast material to be collected compared to traditional needle biopsy, without having to remove the needle at each collection, as the fragments are aspirated into a container and collected at the end of the procedure.
When is this exam indicated?
This technique is used in the case of mammography-guided sampling (mammostereotaxy or tomosynthesis) or Magnetic Resonance Imaging (MRI) in the case of lesions visible only with these techniques, such as areas of microcalcifications, visible only on mammography. This technique is sometimes used in case of discrepancy between the histological result and the suspicious imaging images.
How is it performed?
The examination requires local anesthesia and the sampling is performed by the radiologist, most often guided by mammographic images (mammostereotaxic guidance) or magnetic resonance imaging. As for the core needle biopsy, once in the lesion, the needle allows to collect some fragments of material that are analyzed by the physician pathologist (histological analysis).
The examination lasts between 30 and 45 minutes, in some cases it can be a little annoying due to the aspiration system. To reduce the hematoma that may be caused by the procedure, local compression is applied and ice is applied for about twenty minutes.
If the patient is under treatment with aspirin or anticoagulant therapy it is necessary to point it out during the booking procedure and, when possible, suspend it for two days before and one day after the collection.
It is also necessary to bring the following blood tests: blood count, PT and PTT. Always bring mammograms, breast ultrasounds, breast MRIs or previously performed needle aspiration and needle biopsy. It is essential to bring the examination that required needle biopsy.
Contraindications
None.
Among the various types of sampling, VAB is the most invasive and may involve some side effects such as bleeding, hematoma, edema and small scars. Cases of infection are rare.
Where do we treat it?
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