Diagnostic Test
VAB (Vacuum-Assisted Biopsy)
Description
Vacuum-Assisted Biopsy (VAB) is the gold standard for diagnosis of suspicious breast microcalcifications. It uses a vacuum system that obtains larger and more diagnostically representative tissue samples than conventional CNB. It is usually performed under stereotactic guidance (using mammography to locate lesions not visible by ultrasound) or under ultrasound guidance. It also allows removal of small benign lesions in a single diagnostic-therapeutic procedure.
Practical Information
60 minutes
Light breakfast. Do not apply deodorant or talcum powder. Inform us if you take aspirin, anti-inflammatory drugs, vitamin E, anticoagulants or antiplatelet drugs. Check with your doctor first: do not stop anticoagulants or antiplatelet drugs on your own — this must be indicated by the professional who prescribed them.
Price according to health insurance / private patient
Indications and Recommendations
- BI-RADS 4 and 5 microcalcifications
- Lesions only visible on mammography (not sonographically visible)
- Removal of small lesions (fibroadenomas, B3 lesions)
- Second diagnostic opinion on high-risk lesions
Risks and Complications
- Bruising, sometimes more extensive than with CNB
- Pain after the procedure
- Bleeding, with higher risk in patients on anticoagulant or antiplatelet treatment
- Infection (uncommon)
- Vasovagal reaction (dizziness)
- Low-dose radiation exposure when performed under stereotactic guidance
- Possible need for a further biopsy if the result does not match the imaging findings
Frequently Asked Questions
What is the difference between VAB and CNB?
VAB (Vacuum-Assisted Biopsy) obtains larger and more representative tissue samples than CNB thanks to the vacuum system. It also allows removal of small lesions in a single procedure. It is especially indicated for microcalcifications and lesions not visible by ultrasound that require stereotactic guidance.
What is vacuum-assisted biopsy used for in microcalcifications?
Microcalcifications are only visible on mammography and cannot be biopsied with ultrasound. VAB under stereotactic guidance allows millimetre-precise location of the calcification cluster and obtains sufficient samples for a definitive histological diagnosis, avoiding surgery in most cases.
When is VAB done instead of CNB?
VAB is preferred over CNB when: (1) the lesion consists of microcalcifications without an associated mass; (2) removal of a small benign lesion is desired (e.g. fibroadenoma); (3) a previous CNB has been inconclusive; (4) the lesion has an intermediate-risk diagnosis (B3) requiring excision.
How long does a VAB result take?
The histological result of VAB is available within 5-7 working days. The pathologist analyses the samples and reports on the presence or absence of malignant cells, histological type, grade and, where applicable, hormonal receptors.