Nisha Sharma

Director of Breast Screening Services, Leeds

Secretary of the British Society of Breast Radiology

I am delighted to introduce and support this guidance resource on vacuum assisted excision (VAE). The use of VAE has increased over time. One of the key reasons for this is the management of B3 lesions. The NHS BSP assessment guidance document (publication 49) and the NHS BSP guidelines on the management of B3 lesions (in press) advocates replacing the standard surgical biopsy with VAE. This is an innovative and patient centred pathway that looks to minimise overtreatment in this cohort of women. The UK is leading the way regarding using innovative technologies such as VAE to improve the patient pathway.

There are a number of potential trials looking to build on the role of VAE in managing B3 lesions, to see if this can be extended to patients who have an imaging complete response to chemotherapy in the context of neoadjuvant chemotherapy and whether VAE can be used to manage excellent prognostic tumours and avoid breast surgery in these cohorts of women.

This guidance resource provides support to the users and contains a range of resources such as;

  • Guidelines on management of B3 lesions
  • Protocols for managing women who are on anticoagulant or antiplatelet therapy
  • NHS Coding - Coding statement from NHS Digital about the recognised national codes for vacuum assisted biopsy and excision
  • Business Cases - Business Case Template and Examples
  • Patient Information - Examples of patient leaflets from different centres
  • Education - educational videos and tutorials centred around vacuum biopsies and information regarding masterclasses.

This resource will provide support to the clinical team performing vacuum assisted excision and will also help inform and educate the wider clinical team about what the actual procedure entails. It will also offer patients further insight into what to expect.

With thanks to all Contributors

Ms Victoria Sinnett Consultant Breast Radiographer The Royal Marsden NHS Foundation Trust

Professor John Benson Consultant Surgeon Addenbrooke’s Hospital, Cambridge

Dr Penny Moyle Director of Breast Imaging Cambridge University Hospitals

Dr Nerys Forester Consultant Breast Radiologist The Newcastle Hospitals NHS Foundation Trust

Dr Emma Hughes Consultant Radiologist The Hillingdon Hospitals NHS Foundation Trust

Miss Leena Chagla Consultant Surgeon and Lead Clinician Breast Services St Helens and Knowsley Teaching Hospital NHS Trust

Dr Elena Provenzano Lead Breast Histopathologist Addenbrooke’s Hospital, Cambridge

Dr Arne Juette Consultant Radiologist Norfolk and Norwich University Hospitals NHS Foundation Trust