with patients in the prone position has a known limitation of being unable to target lesions that are far posterior in depth or close to the axilla due to limited positioning.
Directional, vacuum-assisted biopsy
devices are inserted once and rotated while in the breast to obtain cores from multiple lesion sites.
When a malignancy is suspected, we recommend core or vacuum-assisted biopsy
involves the use of suction to pull the tissue into the biopsy window and increase the volume of tissue sampled.
However, more aggressive measures may be used for hemostasis after 11-gauge vacuum-assisted biopsy
, including administration of a local anesthetic with epinephrine for deep anesthesia and wrapping the chest for 24 hours.
The vacuum-assisted biopsy
is a very effective sampling device for MRI.(9)Note that the vacuum console is not MR-compatible, and that only the foot-pedal and biopsy driver can be brought into the MRI suite.(11) Beginning with six samples is reasonable.
Atypical ductal hyperplasia diagnosed at stereotactic breast biopsy: improved reliability with 14-gauge, directional, vacuum-assisted biopsy
If using vacuum-assisted biopsy
(VAB), due to the dead space of the needle distal to the sample notch, which may be up to 1 cm, at least 1.5 cm beyond the area being biopsied, should be anesthetized.
If the hematoma is noted at imaging postbiopsy, using the vacuum-assisted biopsy
device to evacuate the hematoma, followed by direct digital pressure, can be considered (Figure 2).