Scarless removal of breast lump: An introduction to VABB

Through the course of life, a woman’s body undergoes several changes. While some changes are natural, others can be unexpected and anxiety-inducing such as breast lumps. If you feel a lump in your breasts, the first thought that you are likely to have is that of breast cancer. While breast cancer is the most common cancer in India accounting for nearly 14% prevalence, it is not the only disease leading to lumps. Benign (non-cancerous) breast lumps are also highly common. However, benign or malignant, scarless removal of breast lump is possible. 

A breast lump is a localised growth of tissue within the breast. These tissues may or may not be cancerous.

When a woman experiences this atypical growth, she, expectedly, have upheavals of emotions including fear, worry and panic. The next thought in line follows the breast lump removal that again causes distress. It is because according to popular opinion, a breast lump removal surgery leaves a lasting scar that can impact your self-image. 

Nonetheless, advances in medical science have evolved and introduced a new technology for scarless removal of breast lump – Vaccum Assisted Breast Biopsy. 

In this article, Dr Rohan Khandelwal, leading breast surgeon at the CK Birla Hospital, explores this technology, vacuum assisted breast biopsy indications and weighs its pros and cons. 

What is vacuum assisted breast biopsy?

Vacuum assisted breast biopsy (VABB) is an innovative tissue sampling technique. It is a dynamic procedure in which your surgeon can remove a sample of breast tissue through minimal access. 

Vacuum assisted breast biopsy allows surgeons to access breast abnormalities (benign and malignant) through a small and single incision without leaving any scars. 

What are vacuum assisted breast biopsy indications?

A breast biopsy is indicated when a patient displays symptoms of breast abnormality or when she undergoes her routine screening based on her risk factors of the concerned disease. However, an open breast biopsy is not considered a highly preferable option among patients as it causes an altered appearance of your breast which can be a distressing experience. 

As vacuum assisted breast biopsy is a scarless breast surgery intervention. VABB is indicated for both diagnostic and therapeutic reasons. 

Vacuum assisted breast biopsy indications include:

• Non-cancerous breast lump caused by fibroadenomas
• More than one non-cancerous breast lumps 
• Recurrent fibroadenomas
• Persistent spots on the breasts that cause pain 

Vacuum assisted breast biopsy is indicated for the patients lower probability of coming for a follow-up procedure. It may also be recommended in case the patient feels extremely restless and anxious. 

How is scarless removal of breast lump done through VABB?

Breast lump removal as a vacuum assisted excision biopsy is done with the use of state-of-the-art medical equipment. 

Vacuum-assisted breast biopsy for breast lump is a minimally invasive procedure. The removal is done under the influence of anaesthesia to numb the pain. It can be performed in three ways:

• Under the guidance of mammogram exam
• Under the guidance of ultrasound 
• Under the guidance of MRI (Magnetic Resonance Imaging) 

Scarless breast lump removal with VABB under mammogram:

A mammogram exam is used to create real-time images of the insides of your breast. After you are given anaesthesia, your breast surgeon will first locate the breast tissues with the help of an ultrasound. After your surgeon has precisely located the tissues, he/she utilises the vacuum assisted instrument and inserts a special biopsy needle in your breast. Then, he/she draws out several tissue samples. 

After taking enough tissue samples, your surgical team may insert a small titanium marker clip into your breast. This is not be done for every patient. This step is offered to patients who have a higher likelihood of follow-up surgery. A small marker clip makes it easier for the surgeon to locate the area of abnormality later. 

After the tissue sampling is done, your surgeon will only sterilise the area. Stitches are not required in this procedure. If the procedure is being for diagnostic purposes, the sample will be sent to the laboratory for analysis. If the procedure has been to treat an abnormality, the healing period of your treatment journey will begin. 

Scarless breast lump removal with VABB under ultrasound:

In this procedure, your surgeon uses both mammogram exam followed by an ultrasound to more accurately locate the breast lump tissues. 

This guidance type is preferred when the abnormal tissue growth is too small to be visualised only through a mammogram. The rest of the procedure follows the same steps as done with the mammogram-guided scarless breast surgery. 

Scarless breast lump removal with VABB under MRI:

When the breast lump tissues are even smaller, an MRI guidance is used that allows the surgical team receives higher levels of precision to accurately insert the needle. A small needle is placed in your arm to insert a specific liquid dye to enable your surgical team to visualise the lump. 

Proceeded surgery is similar as mentioned above. 

What are the benefits of scarless breast surgery with VABB?

VABB is a very advantageous technique in comparison with open surgical biopsy. Some of the common benefits of this procedure include:

• Single and minimal invasion (<3 mm)
• Does not require stitches
• Rapid recovery
• Minimum discomfort 
• Does not leave any scars 
• Speeds time between detection and diagnosis 
• Higher levels of precision 
• Removes non-cancerous lumps completely 
• Decreases sampling error
• Reduces the likelihood of repeat biopsy
• Sufficient sample collection in a single insertion 
• Easier breast tissue location in women with dense breasts

What are the complications of breast lump removal surgery with VABB?

Scarless removal of breast lump through vacuum assistance is a highly safe method. However, as with other surgical procedures, this biopsy also has the possibility of certain risks and complications. 

Common side-effects include:

• Breast bruising and tenderness
• Bleeding 
• Pain during procedure 
• Slight risk of hematoma 

What happens after scarless removal of breast lump with VABB?

Your surgical team will closely monitor your condition and observe you for a while to avoid any complications, should they occur. Your breast surgeon will give personalised instructions on how to care for your breast. 

• You should take plenty of rest after the procedure 
• You are expected not to carry any heavyweights 
• You might experience some bruising or tenderness which will go away in a few days 
• Your doctor will prescribe medications for breast soreness or tenderness
• Your nursing team will explain to you how to take care of dressing

The concluding note 

Scarless removal of breast lump is already a boon for patients with benign breast disease. However, the added benefits and comfort of vacuum-assisted procedure enhances their treatment journey largely. 

To know more about scarless breast surgery, book an appointment with Dr Rohan Khandelwal, a leading breast surgeon in Gurgaon or visit the CK Birla Hospital. 

FAQs

Ques: Can you get breast lump surgery with no scarring?

Ans: Yes, scarless breast surgery is progressing intervention. Various techniques are available for this procedure for enhanced patient experience and satisfaction. 

Ques: Is vacuum assisted breast biopsy painful? 

Ans: No, since the procedure is performed under anaesthesia, you will not feel any pain. However, you can expect to experience a slight amount of discomfort. 

Ques: How long does a vacuum assisted biopsy take?

Ans: Vacuum assisted biopsy is a simple procedure that lasts only a few hours. You may be able to go home the same day if no complications arise. 

Ques: When should a benign breast lump be removed?

Ans: A benign breast lump such as one caused by fibroadenoma should be removed at the earliest to alleviate symptoms and avoid the risk of complications or long-term implications of the disease.