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CEM Vacuum Assisted Core Biopsy

What is CEM guided biopsy?

A biopsy is a method of collecting a small amount of tissue using a needle, which is then examined by a pathologist for further assessment of possible diseases. A contrast enhanced biopsy uses an iodinated contrast dye to make it easier to find the area of interest. This biopsy is performed using mammographic guidance.

Patients are required to fast for two hours prior to their appointment; however, they may continue drinking water. Please inform us before your appointment if you are taking any blood-thinning medications, have an iodine allergy, have poor kidney function (renal impairment), or are taking Metformin for diabetes, as a recent blood test may be required. If you have difficult veins during blood tests or cannulation, please let our staff know.

Wear loose, comfortable clothing that is easy to remove and put back on.

The procedure usually takes approximately 1 hour.

  • The biopsy will be performed by a specialist breast radiologist, assisted by our radiographers.
  • When you arrive, you will be asked to change into a gown, and an intravenous cannula line will be placed in your arm.
  • You will be seated in a chair for the procedure. The chair may be upright or reclined, depending on the biopsy location.
  • Once you are in position, an iodinated contrast dye will be injected. Two minutes are allowed for the contrast to reach the breast. Your breasts will then be lightly compressed between plates while a digital device helps guide the radiologist during the biopsy.
  • It is normal to feel warm or hot, notice a metallic taste, or feel warmth between the thighs during the injection. These sensations usually pass within two minutes.
  • You will be required to remain very still, as even slight movements may shift your breast position.
  • The radiologist will clean the skin with antiseptic and numb the area with a local anaesthetic. A needle will then be inserted to collect the tissue sample.
  • Several biopsy samples may be required. Staff will explain the procedure and provide guidance on the day.
  • Once collected, the specimen will be sent to pathology for examination, and a report will be forwarded to your doctor. Results are usually available within three working days.
  • A small metal marker or clip will be placed at the biopsy site at the end of the procedure. The clip is very small, MRI-safe, and will not trigger airport security scanners.
  • After your biopsy, you will be given an ice pack. Press the ice pack firmly against the biopsy site (not directly on the skin nick — this location will be indicated by the doctor) for at least ten (10) minutes.
  • The Band-Aid or steristrips covering the skin nick help prevent infection. Avoid getting the area wet until your shower the following morning. To reduce the risk of infection, do not swim or take a bath the next day.
  • After showering, gently pat the steristrips dry and leave them in place for 48 hours.
  • When removing the steristrips, if the nick is wet with fresh blood, apply a standard Band-Aid; otherwise, leave it uncovered. The nick should heal completely within one week.
  • The local anaesthetic will wear off in about two (2) hours. Paracetamol (Panadol or similar) may be taken for pain if needed. Do not take aspirin or non-steroidal anti-inflammatory medications (such as Nurofen), as these may increase bruising.
  • Note: Some patients may be allergic to the adhesive in Band-Aids. Although rare, this may appear as skin irritation such as burning, redness, or blisters.
  • Take it easy for the next 24–48 hours and avoid strenuous upper body activities, including sports, exercise, housework, or heavy lifting.
  • Stay well hydrated to help clear the iodinated contrast dye from your system.

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