Advice after your nerve block for surgery
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Introduction
You have been referred for a vacuum-assisted biopsy (VAB) of the breast. The procedure is performed under mammographic (stereotactic) guidance. This type of breast biopsy is done when your mammogram shows an abnormality such as an area of fine calcification or distortion that cannot be seen by ultrasound. It involves taking small sample of breast tissue using a needle which is attached to gentle suction.
This information tells you about the procedure, what is involved, and what the possible risks are.
Before your appointment
Please let us know if you are taking any medication to thin your blood such as aspirin or anti-coagulants, (e.g., Warfarin, apixaban, rivaroxaban or clopidogrel) or, if you are have any clotting problems.
If you have any known allergies, such as local anaesthetic or dressings.
If you would like another member of staff to be present, to act as a chaperone, during your examination then please let us know when booking in at the reception desk. If you do not request a chaperone, then we will assume that we have your consent to perform the examination without one.
There is no special preparation needed and you can eat and drink as usual.
Please also let us know if:
- you have limited mobility and will require assistance to get on and off a couch.
- you will need an interpreter. We are not able to use family members or friends to interpret.
In order to make your appointment run more smoothly, please let us know if any of these apply, in advance, by calling our bookings team (contact details are displayed on the main Radiology page).
On Arrival
Please arrive 10 minutes before your appointment time.
On arrival in the department, you should check in at the reception desk. Bring this letter with you and be prepared to confirm your details with the receptionist. Please allow time to do this prior to your appointment time and bear in mind that the reception may be busy. Once you have been booked in you will be directed to the waiting area. Please be aware that patients are attending for different examinations and patients who arrive after you may be called before
you.
All patients (ages 12-55) who will undergo a Radiology procedure will be asked about the possibility of them being pregnant, regardless of gender.
What to wear
It is helpful to wear a separate top, and skirt or trousers. After the procedure, we
recommend you wear a non-wired supportive bra.
Giving my consent (permission)
We want to involve you in decisions about your care and treatment. The Radiologist / Advanced Practitioner will ask you if you are happy for the procedure to go ahead - this is called verbal consent. If you do not wish to have the procedure or are undecided, please tell the Radiologist.
It is your decision, and you can change your mind at any time.
If the Radiologist feels that your condition has changed or that your symptoms do not indicate such a procedure is necessary, then they will explain this to you and they will communicate with the referring doctor who will review your situation as soon as possible.
The Procedure
The procedure is performed by a Consultant Radiologist or an Advanced Practitioner
(Mammographer), under mammographic guidance. There will be an additional two
Mammographers in the room, or a Mammographer and a Radiology Assistant.
The skin is cleaned with an antiseptic solution and then local anaesthetic is used to numb the area of the breast. This might sting for a few seconds until it takes effect. When the area is numb, the biopsy needle is inserted through a small cut (less than 5 mm) in the skin. Breast tissue will then be removed using gentle suction. As this happens, you may hear a sucking sound and feel a little pressure. Most patients report that the procedure is a little uncomfortable
but is not painful. Once we have adequate samples, the needle will be removed, and the tissue sample will be sent to Histology for analysis.
It is often necessary to mark the site of the biopsy with a clip in case you need further tests or surgery. A tiny (2 mm) titanium metal clip is inserted through the biopsy needle at the end of the procedure. The clip will remain in your breast if the biopsy results are normal. This should not cause you any problems and is compatible with MRI scans if required in the future and will not set off metal detector alarms. The Clinician will explain about using a breast marker clip
before the procedure begins.
If you have an allergy to metal, please tell us before the procedure. A further mammogram is normally performed at the end of the procedure to see the exact placement of the marker.
After the Examination
Once the biopsy samples have been taken, firm pressure will be applied to the area for 10 minutes to minimise any bruising. Adhesive strips may be used to close the small cut on your breast and the site will then be checked to make sure any bleeding has stopped. A dressing will be applied, and this must be kept dry and remain in place for 48 hours. We will ask you to stay in the department for at least 30 minutes following the procedure for observation.
Most women can return to their normal routine straight after the procedure. However, we recommend that you avoid lifting and strenuous exercise for at least 48 hours.
Risks
- Discomfort: You may experience some discomfort after the procedure when the local anaesthetic wears off. This is usually mild and can be helped with over-the-counter painkillers such as paracetamol if required (avoid taking aspirin or ibuprofen for the first 24 hours). You may find it more comfortable to wear a non-wired supportive bra, day, and night, for two days. Cold compression to the area can also be helpful.
- Bruising: Bruising is common after this procedure. Bruising may make that part of your breast feel lumpy or may affect a wider area. On rare occasions this can be severe and can take several weeks to resolve.
- Bleeding: Occasionally the biopsy site can start bleeding again after you have left the hospital. If this happens, apply firm pressure over the area for 20 minutes. If the bleeding has not stopped after 20 minutes, please contact us.
- Infection: If you experience redness, swelling or tenderness around the injection site, please see your GP or a walk-in clinic within 24 hours as this may require treatment.
- Radiation: If your procedure is performed under Mammographic guidance, then this uses ionising X-ray radiation. Everyone receives ionising radiation every day from radioactivity in the air, food we eat and the sun. Your age, size and the body part being scanned will influence the amount of medical radiation used and theoretical risks of additional exposure.
The benefit of the scan is making the correct diagnosis or treatment plan and a Radiology specialist has agreed that this benefit outweighs the risks of radiation exposure. The radiographers are trained to obtain the best possible imaging using the lowest amount of radiation possible and the equipment is regularly checked to ensure it is safe and effective.
The Results
The results of your test will be made available to the requesting doctor and will usually take about 10-14 working days. You will receive an outpatient appointment to obtain the results.
Contact us
If you have any queries relating to this information, please contact the Radiology service.
About this information
Service:
Radiology
Reference:
PILS-MAMM.12
Approval date:
26 July 2024
Review date:
26 July 2027
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.