The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on image-guided vacuum assisted excision biopsy of benign breast lesions.


This process can be used to remove completely benign breast lesions for example fibroadenomas. It uses a needle probe device with vacuum suction to remove breast tissue under imaging guidance (commonly ultrasound). The aim of the procedure is to continue using the biopsy device until the lesion visible on imaging is removed.

Coding recommendations

B28.3 Excision of lesion of breast NEC

Y06.6 Vacuum excision of lesion of organ NOC

Includes: Vacuum assisted excision of lesion of organ NOC

Y53.- Approach to organ under image control

Note: Codes within category Y53.- are used as secondary codes to classify interventions that are percutaneous and require some form of image control: if the method of image control is unspecified, Y53.9 Unspecified approach to organ under image control is assigned.

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.