Breast Biopsy in Singapore: Minimally Invasive Diagnosis & Treatment
At Breast Surgery Care Partners, we offer breast biopsy techniques such as Core Needle Biopsy (CNB), Vacuum Assisted Biopsy (VAB) and Vacuum Assisted Excision (VAE) to provide accurate diagnosis and potential treatment with minimal discomfort, scarring, and downtime. Our minimally invasive approach ensures reliable tissue sampling and effective management of both benign and suspicious breast conditions.
What Is a Breast Biopsy?
A breast biopsy is a procedure used to obtain a sample of tissue for diagnosis when imaging shows a suspicious abnormality which can present in the form of a lump, microcalcifications, architectural distortion and more.
The most commonly discussed method of biopsy is the image-guided core needle biopsy (CNB), which is a tissue sampling procedure which aims to establish a diagnosis, but does not eradicate the target lesion. These are suitable when the suspicious lesion is more likely to require definitive therapy such as surgery, or may be conservatively managed if biopsy results are reassuring. On the other hand, surgical excision involves a formal incision and lesion removal, in an operating theater, under general anaesthesia.
More recently, image-guided minimally invasive methods of tissue removal – particularly Vacuum Assisted Biopsy (VAB) and Vacuum Assisted Excision (VAE) – offer a more precise, efficient, and comfortable way to both diagnose and treat certain breast conditions.
All extracted tissue is sent to a laboratory for histological assessment, analyzed by a pathologist under a microscope, to provide you with a clear diagnosis, and in the case of VAB or VAE, possibly complete treatment.
Why Choose Minimally Invasive Procedures?
Breast health concerns can be overwhelming. At Breast Surgery Care Partners, we acknowledge the multitude of available options that may bring about feelings of uncertainty and anxiety. We are dedicated to offering a supportive environment, utilising the most advanced imaging technologies and surgical techniques, to achieve unparalleled accuracy in diagnosis and treatment.
In the diagnostic evaluation and management of breast conditions, ranging from benign breast disease, to high-risk lesions and breast cancer, our goal is minimal incisions, preservation of healthy breast tissue, with a seamless and precise approach to patient care.
Minimal Scarring
Minimal Pain
Minimal Downtime
Minimally Invasive Breast Biopsy and Excision
Following initial clinical evaluation and breast imaging, we will find that the majority of benign breast lesions do not require biopsy or removal. However, our breast specialist may recommend tissue biopsy or removal for suspected cancers, indeterminate high-risk lesions (B3 lesions; lesions of uncertain malignant potential), or evolving or symptomatic growths. Some benign non-cancerous lesions may also be recommended for sampling or removal because they are symptomatic, changing, growing, concerning, or simply for diagnosis, clarity and to direct definitive treatment.
A biopsy is an invasive examination of tissue removed from one’s body to diagnose the presence, cause, or extent of a disease. The extracted tissue is then sent to a laboratory for histological assessment. The tissue and cells are analysed by a pathologist under a microscope to provide you with a diagnosis to guide recommendations on subsequent management and surveillance.
Our procedures include:
Core Needle Biopsy (CNB)
A needle sampling procedure performed to obtain tissue for pathological testing.
Vacuum-Assisted Biopsy (VAB)
An extended tissue sampling procedure aided by vacuum suction in order to remove a wider region of tissue samples for pathological testing.
Vacuum-Assisted Excision (VAE)
A minimally invasive alternative to conventional surgical excision.
Understanding the Different Options for
Minimally Invasive Breast Biopsy
A breast biopsy is a procedure used to obtain tissue for diagnosis when imaging shows a suspicious abnormality which can present in the form of a lump, microcalcifications, architectural distortion and others.
Core Needle Biopsy (CNB)
A core needle biopsy (CNB) of a breast lesion is a needle sampling procedure performed to obtain a sample of tissue for pathological testing. This is a tissue sampling procedure which aims to establish a diagnosis, but does not eradicate the target lesion.
These are suitable when the suspicious lesion is more likely to require definitive therapy such as surgery, or may be conservatively managed if biopsy results are reassuring.
Vacuum Assisted Biopsy (VAB)
A vacuum assisted biopsy (VAB) is primarily a tissue sampling procedure using a tiny skin nick and introduction of needle device. The procedure is aided by vacuum suction and often aims to completely remove the lesion.
Benefits of VAB compared to core needle biopsy:- More samples for higher diagnostic accuracy, complete lesion removal, and the ability to assess the entire lesion under the microscope
- High precision guided by imaging
- Only local anaesthesia required, with the option of moderate sedation
- No stitches
- Minimal scarring, barely perceptible
- Quick recovery, almost no downtime
VAB is one of the most minimally invasive breast biopsy methods of diagnosis and treatment available today.
Vacuum Assisted Excision (VAE)
Vacuum-Assisted Excision (VAE) is a minimally invasive alternative to surgical removal of benign or indeterminate breast lesions. Using the same tiny incision as VAB, VAE removes the entire lump without the need for open surgery.
When VAE is recommended:- For benign breast lumps such as fibroadenomas when there are clinical or personal concerns
- For high-risk lesions (i.e. B3 lesions; Lesions of Uncertain Malignant Potential) that require complete removal
- For symptomatic, growing, or bothersome masses
- When patients prefer a scar-minimising option instead of surgery
- Minimal scarring
- Less pain and bruising
- Performed under local anaesthesia, with an option of moderate sedation for comfort
- No stitches required
- Minimal scarring
- Faster recovery compared to open surgical excision with minimal downtime
- Lovely cosmetic outcome
VAE offers an effective, cosmetic-friendly solution for many women without the need for full surgical excision.
Who Is Suitable for These Procedures?
You may be recommended a minimally invasive breast biopsy, VAB, or VAE if you have abnormal imaging findings on ultrasound, mammogram, or MRI of the breast, such as:
- Suspicious lumps
- Suspicious microcalcifications
- Architectural distortions
- Suspicious non-mass enhancement
- A benign mass that is painful, enlarging, or cosmetically concerning
- High-risk or indeterminate lesions needing further evaluation and treatment
- A preference for scar-minimising alternatives to surgery
Your breast specialist will advise the most appropriate technique based on your imaging and clinical findings.
What to Expect: Before, During & After a Minimally Invasive Vacuum Assisted Procedure
Before the Procedure
- You will undergo breast imaging (ultrasound, mammogram, or MRI)
- Your specialist will explain the procedure and expected outcomes
- Local anaesthesia will be used, with the option of moderate sedation
During the Procedure
- A tiny incision is made (usually 3–5 mm)
- The biopsy device (VAB or VAE) is guided by imaging modalities such as ultrasound, mammography, or MRI to the lesion
- Once positioned, the device gently draws tissue into the probe. The vacuum holds onto the target lesion, the cutter removes it in precise sections, continuously collecting the removed tissue.
- The incision is covered with a small dressing — no sutures needed.
With such advancement in technology and precision in the operator’s skillset, lesions can be excised thoroughly and safely in a minimally invasive manner.
After the Procedure
- Mild bruising or tenderness for a few days
- You can return to normal activities, with caution to your upper body for 3 days
- Results are typically available within several working days to a week
- Your specialist will discuss follow-up or treatment if needed
Benefits of Minimally Invasive Breast Biopsy
These techniques combine accuracy with great cosmetic preservation.
Advanced Localisation Techniques
When complete surgical removal is necessary for small lesions that cannot be obviously felt, we utilise advanced localisation techniques, including non-wire options to ensure precise excision and maximal patient comfort. Such lesions are usually screen-detected or imperceptible incidental imaging findings.
Hookwire Localisation
A reliable conventional method of localisation involving placement of a fine wire to mark the location of the lesion for the purpose of surgical excision. Limitations include the presence of an external wire component, risk of wire migration, fragmentation and discomfort.
Non-Wire Localisation Methods
- Magnetic Seed Localisation: A tiny 3.2mm ferromagnetic marker provides visual, auditory, distance and directional feedback to your surgeon via a handheld detector. It has been never shown to break, deactivate or lose signal, and remains detectable through dense breasts and blood clots. The marker can be placed anytime within 30 days before surgery at the patient and surgeon’s convenience.
- Radar Localisation: A small electromagnetic wave reflector delivers non-radioactive infra-red and radar signals to a handheld detector. The surgeon receives both auditory feedback and real-time distance measurement over a wide detection range with ± 1mm accuracy, and proven reliability of 99.2%. The marker can be placed any time before surgery and is safe for long-term placement should further extraction be unnecessary. It produces very little MRI artifact and does not significantly affect MRI interpretation.
- Other Options: Radioactive seed localisation, Radio-frequency identification (RFID) tag localisation, and more.
Non-wire localisation methods take away challenges and complications associated with the use of a wire and increase precision and accuracy when a small localiser is placed at a single point. This allows the surgeon to have more creative freedom to plan incisions and approaches, and reduces the volume of non-targeted breast tissue excised. As there is no wire protruding from the patient’s breast, this also improves overall comfort.
Meet our Breast Surgeon
Dr Sabrina Ngaserin
Senior Consultant
Oncoplastic and Minimally Invasive Breast Surgeon
Breast surgeon subspecialising in surgical oncology.
One of the few breasts surgeons in the world formally trained in both
oncoplastic breast surgery and minimally invasive endoscopic breast
surgery.Pioneer of Minimally Invasive ‘Keyhole’ Breast Surgery in Singapore.
Former Head of Breast Surgery and Senior Consultant at Sengkang General Hospital and SingHealth Duke-NUS Breast Centre.
Visiting Senior Consultant at the National University Hospital (NUH)
Singapore.Adjunct Assistant Professor at Duke-NUS Post-graduate Medical School and Yong Loo Lin School of Medicine, National University of Singapore.
Ministry of Health of Singapore and Singapore Medical Council certified
specialist.Fellowship accredited by the Royal College of Surgeons of Edinburgh and
Academy of Medicine Singapore.
Meet our Breast Surgeon
Dr Sabrina Ngaserin Ng Hui Na
Senior Consultant
Oncoplastic and Minimally Invasive Breast Surgeon
Breast surgeon subspecialising in surgical oncology.
One of the few breasts surgeons in the world formally trained in both
oncoplastic breast surgery and minimally invasive endoscopic breast surgery.Pioneer of Minimally Invasive ‘Keyhole’ Breast Surgery in Singapore.
Former Head of Breast Surgery and Senior Consultant at Sengkang General Hospital and SingHealth Duke-NUS Breast Centre.
Visiting Senior Consultant at the National University Hospital (NUH) Singapore.
Adjunct Assistant Professor at Duke-NUS Post-graduate Medical School and Yong Loo Lin School of Medicine, National University of Singapore.
Ministry of Health of Singapore and Singapore Medical Council certified specialist.
Fellowship accredited by the Royal College of Surgeons of Edinburgh and Academy of Medicine Singapore.
Frequently Asked Questions
Most patients experience only mild pressure or discomfort. Local anaesthesia ensures the procedure is well tolerated. Moderate sedation can make the procedure more comfortable.
Breast biopsy results typically return within a few working days to a week, depending on the complexity of the tissue analysis.
VAE goes one step further than VAB:
A vacuum assisted biopsy (VAB) is primarily a tissue sampling procedure using a 10 to 12 Gauge sized needle; the procedure is aided by vacuum suction and often aims to completely remove the lesion.
A vacuum assisted excision (VAE) is a minimally invasive alternative to a diagnostic surgical excision. VAE uses the same VAB technique to remove the entire lesion and a rim of surrounding breast tissue, often utilising a larger 7 to 8 Gauge sized needle.
Only a tiny 3–5 mm scar remains, usually barely noticeable and often fading over time.
Most patients resume normal activities within the day, with minimal bruising or discomfort. Light activities are recommended for 72 hours.
Yes, for suitable cases. VAB and VAE provide highly reliable tissue sampling while avoiding the trauma and scarring of open surgery.
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