Vacuum-assisted biopsy devices (VAB) typically use needles from 8-gauge to 11-gauge. They extract with one specimen significant more tissue compared with a 14-gauge core needle. The prior indication for this device is the clearing of suspicious calcifications mostly under stereotactic guidance [3, 6, 7]. For this guidance-technique a + 15 and a − 15 stereotactic image is obtained. In both stereotactic images the target is defined and the depth of the lesion is computer calculated. Pre- and postfire stereotactic images document the needle position (Fig. 2).

The ultrasound guided vacuum-assisted biopsy technique [3, 4] is used to compensate a poor visible ultrasound target, e.g., a diffuse growing lesion with or without palpable tissue stiffening, because of a bigger amount of removed tissue. Performing an ultrasound guided vacuum–assisted biopsy after administration of local anesthesia the biopsy needle is placed under the lesion not to hide a part of the lesion due to needle artefacts Fig. 3a–c. The option to remove a benign breast lesion of about 2.5 cm long-axis diameter is offered by this ultrasound guided vacuum-assisted biopsy technique Fig. 3d, e [8]. The documentation before biopsy is done in the same way as stated above for the large core needle biopsy in the postfire position. Using 3D–ultrasound a three-dimensional data set is acquired before and after biopsy. After tissue-extraction a marker should be inserted to make clear where the rest of the lesion is or the lesion was located.