Biopsy for Breast Cancer Diagnosis

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Biopsy for Breast Cancer Diagnosis:

Fine Needle Aspiration BiopsyYour health care providers may refer you for a fine needle aspiration biopsy (FNA) if a lump is discovered in your

breast. The FNA biopsy is used to assess the lump. In the past, this required a sometimes painful surgical procedure

that involved a longer waiting period for the results. With FNA, a sample of the lump is obtained using a small, thinneedle. The test often allows doctors to make a diagnosis within two to three days of the test.

How Is the Biopsy Performed?

Your doctor will ask some questions about the lump:

Where it is?

How and when you first became aware of it?

Have you noticed any changes in it?

Next, the doctor will feel the lump. Before the actual biopsy is performed the doctor will give you an opportunity to ask

any questions or express any concerns you might have about the procedure. After all your questions and concerns

have been addressed, the actual procedure will begin.

Holding the lump with one hand, the doctor will precisely sample the lump with a thin needle held in a needle holder,

which provides greater control. Usually, two to three samples will be required from the lump to provide an accurate

diagnosis. During the procedure, the doctor will usually leave the examination room with one of the slides to check

that there is enough tissue to prevent the need for a second office visit.

How Long Does the Procedure Take?

Each sample takes about 10 to 20 seconds to obtain. The whole procedure from start to finish usually takes no more

than 10 to 15 minutes. However, please allow an hour for your visit because of registration and possible waiting time

in the office.

When Will I Get My Results?

Generally, your results should be available from your surgeon's office in two to three working days. The results can

be grouped into three categories:

Clearly benign

not cancer Clearly malignant cancer

Non-definitive, less clear most often, this will be followed by asurgical biopsy

How Reliable Is This Test?

In the hands of a skilled FNA practitioner, this test is very reliable. In the instance of a clearly benign diagnosis, it may

prevent you from undergoing surgery. In the case of a clearly malignant diagnosis, it quickly establishes the need for

further treatment. In the less frequent occurrence of a non-definitive diagnosis, either repetition of the FNA or a

surgical biopsy is usually recommended.

Our experience at UCSF Medical Center has demonstrated a 2 percent to 3 percent chance that a cancer may not be

detected. This is why you will be asked to come back for a follow-up visit. We also take into account the result of any

imaging studies, such as a mammogram or ultrasound scan, and how the lump feels to your doctor. By doing this, the

chance of missing a cancer is reduced to less than 1 percent.

What Complications Might Arise?

When carried out by an experienced practitioner, a fine needle aspiration biopsy is virtually free of significant

complications. The most common complication is a slight bruising or tenderness of the area for a few days following

the procedure. Discomfort should be relieved by an over-the-counter pain reliever such as Tylenol or the application

of an icepack for short periods following your return home.

Please call theBreast Care Centerimmediately if you experience any of the following symptoms after your

biopsy:
http://www.ucsfhealth.org/education/biopsy_for_breast_cancer_diagnosis/surgical_breast_biopsy/index.htmlhttp://www.ucsfhealth.org/education/biopsy_for_breast_cancer_diagnosis/surgical_breast_biopsy/index.htmlhttp://www.ucsfhealth.org/education/biopsy_for_breast_cancer_diagnosis/surgical_breast_biopsy/index.htmlhttp://www.ucsfhealth.org/clinics/carol_franc_buck_breast_care_center/index.htmlhttp://www.ucsfhealth.org/clinics/carol_franc_buck_breast_care_center/index.htmlhttp://www.ucsfhealth.org/clinics/carol_franc_buck_breast_care_center/index.htmlhttp://www.ucsfhealth.org/clinics/carol_franc_buck_breast_care_center/index.htmlhttp://www.ucsfhealth.org/education/biopsy_for_breast_cancer_diagnosis/surgical_breast_biopsy/index.html


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Swelling that doesn't go away

Continued bleeding

A fever over 101 degree Fahrenheit (38.3 degree Celsius)

Pain that is not helped by Tylenol or other non-aspirin products

Fine-needle aspirationFrom Wikipedia, the free encyclopedia

"FNA" redirects here. For other uses, seeFNA (disambiguation).

Fine-needle aspiration

Diagnostics

Micrographof a needle aspiration biopsy specimen of asalivary

glandshowingadenoid cystic carcinoma. Pap stain.

MeSH D044963

Fine-needle aspiration biopsy (FNAB, FNA orNAB), orfine-needle aspiration cytology (FNAC), is a

diagnostic procedure used to investigate superficial (just under the skin) lumps or masses. In this technique, a

thin, hollowneedleis inserted into the mass forsamplingof cells that, after being stained, will be examined

under amicroscope. There could be cytology exam of aspirate (cell specimen evaluation, FNAC) or histological

(biopsy- tissue specimen evaluation, FNAB).[1]

Fine-needle aspiration biopsies are very safe,

minorsurgicalprocedures. Often, a major surgical (excisional or open) biopsy can be avoided by performing a

needle aspiration biopsy instead. In 1981, the first fine-needle aspiration biopsy in the United States was done

atMaimonides Medical Center, eliminating the need for surgery and hospitalization. Today, this procedure is

widely used in the diagnosis of cancer.[2]
http://en.wikipedia.org/wiki/FNA_(disambiguation)http://en.wikipedia.org/wiki/FNA_(disambiguation)http://en.wikipedia.org/wiki/FNA_(disambiguation)http://en.wikipedia.org/wiki/Micrographhttp://en.wikipedia.org/wiki/Micrographhttp://en.wikipedia.org/wiki/Salivary_glandhttp://en.wikipedia.org/wiki/Salivary_glandhttp://en.wikipedia.org/wiki/Salivary_glandhttp://en.wikipedia.org/wiki/Salivary_glandhttp://en.wikipedia.org/wiki/Adenoid_cystic_carcinomahttp://en.wikipedia.org/wiki/Adenoid_cystic_carcinomahttp://en.wikipedia.org/wiki/Pap_stainhttp://en.wikipedia.org/wiki/Pap_stainhttp://en.wikipedia.org/wiki/Pap_stainhttp://en.wikipedia.org/wiki/Medical_Subject_Headingshttp://www.nlm.nih.gov/cgi/mesh/2011/MB_cgi?field=uid&term=D044963http://en.wikipedia.org/wiki/Hypodermic_needlehttp://en.wikipedia.org/wiki/Hypodermic_needlehttp://en.wikipedia.org/wiki/Hypodermic_needlehttp://en.wikipedia.org/wiki/Sampling_(medicine)http://en.wikipedia.org/wiki/Sampling_(medicine)http://en.wikipedia.org/wiki/Sampling_(medicine)http://en.wikipedia.org/wiki/Microscopehttp://en.wikipedia.org/wiki/Microscopehttp://en.wikipedia.org/wiki/Microscopehttp://en.wikipedia.org/wiki/Biopsyhttp://en.wikipedia.org/wiki/Biopsyhttp://en.wikipedia.org/wiki/Biopsyhttp://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_note-1http://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_note-1http://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_note-1http://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Maimonides_Medical_Centerhttp://en.wikipedia.org/wiki/Maimonides_Medical_Centerhttp://en.wikipedia.org/wiki/Maimonides_Medical_Centerhttp://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_note-2http://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_note-2http://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_note-2http://en.wikipedia.org/wiki/File:Adenoid_cystic_carcinoma_cytology.jpghttp://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_note-2http://en.wikipedia.org/wiki/Maimonides_Medical_Centerhttp://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_note-1http://en.wikipedia.org/wiki/Biopsyhttp://en.wikipedia.org/wiki/Microscopehttp://en.wikipedia.org/wiki/Sampling_(medicine)http://en.wikipedia.org/wiki/Hypodermic_needlehttp://www.nlm.nih.gov/cgi/mesh/2011/MB_cgi?field=uid&term=D044963http://en.wikipedia.org/wiki/Medical_Subject_Headingshttp://en.wikipedia.org/wiki/Pap_stainhttp://en.wikipedia.org/wiki/Adenoid_cystic_carcinomahttp://en.wikipedia.org/wiki/Salivary_glandhttp://en.wikipedia.org/wiki/Salivary_glandhttp://en.wikipedia.org/wiki/Micrographhttp://en.wikipedia.org/wiki/FNA_(disambiguation)


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Suspension of bloodanticoagulantmedications;

Antibioticprophylaxismay be instituted.

Before the procedure is started, vital signs (pulse,blood pressure, temperature, etc.) may be taken. Then,

depending on the nature of the biopsy, anintravenous linemay be placed. Very anxious patients may want to

be given sedation through this line. For patients with less anxiety, oral medication (Valium) can be prescribed to

be taken before the procedure.

Procedure[edit]

A physician's hands are seen performing a needle biopsy to determine nature of lump either fluid-filled cyst or solid tumor.

Theskinabove the area to be biopsied is swabbed with anantisepticsolution and draped with sterile surgical

towels. The skin, underlyingfat, andmusclemay be numbed with alocal anesthetic, although this is often not

necessary with superficial masses. After locating the mass for biopsy, using x-rays orpalpation, a special

needle of very fine diameter is passed into the mass. The needle may be inserted and withdrawn several times.

There are many reasons for this:

One needle may be used as a guide, with the other needles placed along it to achieve a more precise

position.

Sometimes, several passes may be needed to obtain enough cells for the intricate tests which the

cytopathologists perform.

After the needles are placed into the mass, cells are withdrawn by aspiration with asyringeand spread on a

glass slide. The patient's vital signs are taken again, and the patient is removed to an observation area forabout 3 to 5 hours.

For biopsies in the breast, ultrasound-guided fine needle biopsy is the most common.
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Post-operative care and complications[edit]

As with any surgical procedure, complications are possible. Fortunately, major complications due to thin needle

aspiration biopsies are fairly uncommon, and when complications do occur, they are generally mild. The kind

and severity of complications depend on the organs from which a biopsy is taken or the organs gone through toobtain cells.

After the procedure, mild analgesics are used to control post-operative pain. Aspirin or aspirin substitutes

should not be taken for 48 hours after the procedure (unless aspirin is prescribed for a cardiac or neurological

condition). Since sterility is maintained throughout the procedure,infectionis rare. But should an infection

occur, it will be treated withantibiotics.Bleedingis the most common complication of this procedure. A slight

bruise may also appear. If alungorkidneybiopsy has been performed, it is very common to see a small

amount of blood insputumorurineafter the procedure. Only a small amount of bleeding should occur. During

the observation period after the procedure, bleeding should decrease over time. If more bleeding occurs, this

will be monitored until it subsides. Rarely, major surgery will be necessary to stop the bleeding.

A recent study showed that in one case a needle biopsy of a liver tumor resulted in spread of the cancer along

the path of the needle, and concluded that needle aspiration was dangerous and unnecessary. The

conclusions drawn from this paper were strongly criticized subsequently.[4]

Other complications depend upon the body part on which the biopsy takes place:

Lung biopsies are frequently complicated bypneumothorax(collapsed lung). This complication can also

accompany biopsies in the upperabdomennear the base of the lung. About one-quarter to one-half of

patients having lung biopsies will develop pneumothorax. Usually, the degree of collapse is small and

resolves on its own without treatment. A small percentage of patients will develop a pneumothorax serious

enough to require hospitalization and placement of achest tubefor treatment. Although it is impossible to

predict in whom this will occur, collapsed lungs are more frequent and more serious in patients with severe

emphysema and in patients in whom the biopsy is difficult to perform.

Forbiopsies of the liver,bileleakages may occur, but these are quite rare.

Pancreatitis(inflammation of thepancreas) may occur after biopsies in the area around the pancreas.

Deaths have been reported from needle aspiration biopsies, but such outcomes are extremely rare.

References[edit]

1. ^http://www.indepreviews.com/article/2011/vol-13-no-1/006-084-FINE-NEEDLE-ASPIRATION-

CYTOLOGY-%28F-N-A-C%29.pdf

2. ^http://www.maimonidesmed.org/Main/CultureofInnovation.aspx, First US Procedure
http://en.wikipedia.org/w/index.php?title=Fine-needle_aspiration&action=edit&section=4http://en.wikipedia.org/w/index.php?title=Fine-needle_aspiration&action=edit&section=4http://en.wikipedia.org/w/index.php?title=Fine-needle_aspiration&action=edit&section=4http://en.wikipedia.org/wiki/Infectionhttp://en.wikipedia.org/wiki/Infectionhttp://en.wikipedia.org/wiki/Infectionhttp://en.wikipedia.org/wiki/Antibioticshttp://en.wikipedia.org/wiki/Antibioticshttp://en.wikipedia.org/wiki/Antibioticshttp://en.wikipedia.org/wiki/Bleedinghttp://en.wikipedia.org/wiki/Bleedinghttp://en.wikipedia.org/wiki/Bleedinghttp://en.wikipedia.org/wiki/Lunghttp://en.wikipedia.org/wiki/Lunghttp://en.wikipedia.org/wiki/Lunghttp://en.wikipedia.org/wiki/Kidneyhttp://en.wikipedia.org/wiki/Kidneyhttp://en.wikipedia.org/wiki/Kidneyhttp://en.wikipedia.org/wiki/Sputumhttp://en.wikipedia.org/wiki/Sputumhttp://en.wikipedia.org/wiki/Sputumhttp://en.wikipedia.org/wiki/Urinehttp://en.wikipedia.org/wiki/Urinehttp://en.wikipedia.org/wiki/Urinehttp://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_note-4http://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_note-4http://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_note-4http://en.wikipedia.org/wiki/Pneumothoraxhttp://en.wikipedia.org/wiki/Pneumothoraxhttp://en.wikipedia.org/wiki/Pneumothoraxhttp://en.wikipedia.org/wiki/Abdomenhttp://en.wikipedia.org/wiki/Abdomenhttp://en.wikipedia.org/wiki/Abdomenhttp://en.wikipedia.org/wiki/Chest_tubehttp://en.wikipedia.org/wiki/Chest_tubehttp://en.wikipedia.org/wiki/Chest_tubehttp://en.wikipedia.org/wiki/Liver_biopsyhttp://en.wikipedia.org/wiki/Liver_biopsyhttp://en.wikipedia.org/wiki/Liver_biopsyhttp://en.wikipedia.org/wiki/Bilehttp://en.wikipedia.org/wiki/Bilehttp://en.wikipedia.org/wiki/Bilehttp://en.wikipedia.org/wiki/Pancreatitishttp://en.wikipedia.org/wiki/Pancreatitishttp://en.wikipedia.org/wiki/Pancreashttp://en.wikipedia.org/wiki/Pancreashttp://en.wikipedia.org/wiki/Pancreashttp://en.wikipedia.org/w/index.php?title=Fine-needle_aspiration&action=edit&section=5http://en.wikipedia.org/w/index.php?title=Fine-needle_aspiration&action=edit&section=5http://en.wikipedia.org/w/index.php?title=Fine-needle_aspiration&action=edit&section=5http://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_ref-1http://www.indepreviews.com/article/2011/vol-13-no-1/006-084-FINE-NEEDLE-ASPIRATION-CYTOLOGY-%28F-N-A-C%29.pdfhttp://www.indepreviews.com/article/2011/vol-13-no-1/006-084-FINE-NEEDLE-ASPIRATION-CYTOLOGY-%28F-N-A-C%29.pdfhttp://www.indepreviews.com/article/2011/vol-13-no-1/006-084-FINE-NEEDLE-ASPIRATION-CYTOLOGY-%28F-N-A-C%29.pdfhttp://www.indepreviews.com/article/2011/vol-13-no-1/006-084-FINE-NEEDLE-ASPIRATION-CYTOLOGY-%28F-N-A-C%29.pdfhttp://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_ref-2http://www.maimonidesmed.org/Main/CultureofInnovation.aspxhttp://www.maimonidesmed.org/Main/CultureofInnovation.aspxhttp://www.maimonidesmed.org/Main/CultureofInnovation.aspxhttp://www.maimonidesmed.org/Main/CultureofInnovation.aspxhttp://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_ref-2http://www.indepreviews.com/article/2011/vol-13-no-1/006-084-FINE-NEEDLE-ASPIRATION-CYTOLOGY-%28F-N-A-C%29.pdfhttp://www.indepreviews.com/article/2011/vol-13-no-1/006-084-FINE-NEEDLE-ASPIRATION-CYTOLOGY-%28F-N-A-C%29.pdfhttp://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_ref-1http://en.wikipedia.org/w/index.php?title=Fine-needle_aspiration&action=edit&section=5http://en.wikipedia.org/wiki/Pancreashttp://en.wikipedia.org/wiki/Pancreatitishttp://en.wikipedia.org/wiki/Bilehttp://en.wikipedia.org/wiki/Liver_biopsyhttp://en.wikipedia.org/wiki/Chest_tubehttp://en.wikipedia.org/wiki/Abdomenhttp://en.wikipedia.org/wiki/Pneumothoraxhttp://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_note-4http://en.wikipedia.org/wiki/Urinehttp://en.wikipedia.org/wiki/Sputumhttp://en.wikipedia.org/wiki/Kidneyhttp://en.wikipedia.org/wiki/Lunghttp://en.wikipedia.org/wiki/Bleedinghttp://en.wikipedia.org/wiki/Antibioticshttp://en.wikipedia.org/wiki/Infectionhttp://en.wikipedia.org/w/index.php?title=Fine-needle_aspiration&action=edit&section=4


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3. ^Chorionic villus sampling and amniocentesis: information for youfromRoyal College of Obstetricians and

Gynaecologists. Date published: 01/06/2006

4. ^"bmj.com". Retrieved 2010-03-14.

Originally adapted fromPreparing for a needle aspiration biopsy(634 KB). Public domain text of

theNational Institutes of HealthWarren Magnuson Grant Clinical Center.

All about ultrasound-guided fine needle biopsy

External links[edit]

Aspiration Biopsy, Fine-Needleat the US National Library of MedicineMedical Subject Headings(MeSH)

Breast

-462749619atGPnotebook- "fine needle aspiration cytology (breast)"

Lung

MedlinePlus Encyclopedia003860- "Lung needle biopsy"

Neck

ent/561ateMedicine- "Fine-Needle Aspiration of Neck Masses"

MedlinePlus Encyclopedia003899- "Thyroid nodule fine needle aspirate"

Bone

MedlinePlus Encyclopedia003658- "Bone marrow aspiration"

med/2971ateMedicine- "Bone Marrow Aspiration and Biopsy"

Fine Needle Aspiration (Fine Needle Biopsy)

BiopsyPDF, 135KB

Breast Cancer 101 (Interactive Multimedia) - Needle BiopsyMacromedia Flash
http://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_ref-3http://www.rcog.org.uk/womens-health/clinical-guidance/chorionic-villus-sampling-cvs-what-you-need-knowhttp://www.rcog.org.uk/womens-health/clinical-guidance/chorionic-villus-sampling-cvs-what-you-need-knowhttp://www.rcog.org.uk/womens-health/clinical-guidance/chorionic-villus-sampling-cvs-what-you-need-knowhttp://en.wikipedia.org/wiki/Royal_College_of_Obstetricians_and_Gynaecologistshttp://en.wikipedia.org/wiki/Royal_College_of_Obstetricians_and_Gynaecologistshttp://en.wikipedia.org/wiki/Royal_College_of_Obstetricians_and_Gynaecologistshttp://en.wikipedia.org/wiki/Royal_College_of_Obstetricians_and_Gynaecologistshttp://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_ref-4http://bmj.bmjjournals.com/cgi/content/full/328/7438/507http://bmj.bmjjournals.com/cgi/content/full/328/7438/507http://bmj.bmjjournals.com/cgi/content/full/328/7438/507http://www.cc.nih.gov/ccc/patient_education/pepubs/needle.pdfhttp://www.cc.nih.gov/ccc/patient_education/pepubs/needle.pdfhttp://www.cc.nih.gov/ccc/patient_education/pepubs/needle.pdfhttp://en.wikipedia.org/wiki/National_Institutes_of_Healthhttp://en.wikipedia.org/wiki/National_Institutes_of_Healthhttp://en.wikipedia.org/wiki/National_Institutes_of_Healthhttp://oncolex.org/en/Breast%20cancer/Procedures/DIAGNOSTICS/Ultralydveiledet%20finnalbiopsi%20bryst?lg=procedurehttp://oncolex.org/en/Breast%20cancer/Procedures/DIAGNOSTICS/Ultralydveiledet%20finnalbiopsi%20bryst?lg=procedurehttp://en.wikipedia.org/w/index.php?title=Fine-needle_aspiration&action=edit&section=6http://en.wikipedia.org/w/index.php?title=Fine-needle_aspiration&action=edit&section=6http://en.wikipedia.org/w/index.php?title=Fine-needle_aspiration&action=edit&section=6http://www.nlm.nih.gov/cgi/mesh/2011/MB_cgi?mode=&term=Aspiration+Biopsy,+Fine-Needlehttp://www.nlm.nih.gov/cgi/mesh/2011/MB_cgi?mode=&term=Aspiration+Biopsy,+Fine-Needlehttp://en.wikipedia.org/wiki/Medical_Subject_Headingshttp://en.wikipedia.org/wiki/Medical_Subject_Headingshttp://en.wikipedia.org/wiki/Medical_Subject_Headingshttp://www.gpnotebook.co.uk/simplepage.cfm?ID=-462749619http://www.gpnotebook.co.uk/simplepage.cfm?ID=-462749619http://en.wikipedia.org/wiki/GPnotebookhttp://en.wikipedia.org/wiki/GPnotebookhttp://en.wikipedia.org/wiki/GPnotebookhttp://en.wikipedia.org/wiki/MedlinePlushttp://www.nlm.nih.gov/medlineplus/ency/article/003860.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003860.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003860.htmhttp://www.emedicine.com/ent/topic561.htmhttp://www.emedicine.com/ent/topic561.htmhttp://en.wikipedia.org/wiki/EMedicinehttp://en.wikipedia.org/wiki/EMedicinehttp://en.wikipedia.org/wiki/EMedicinehttp://en.wikipedia.org/wiki/MedlinePlushttp://www.nlm.nih.gov/medlineplus/ency/article/003899.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003899.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003899.htmhttp://en.wikipedia.org/wiki/MedlinePlushttp://www.nlm.nih.gov/medlineplus/ency/article/003658.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003658.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003658.htmhttp://www.emedicine.com/med/topic2971.htmhttp://www.emedicine.com/med/topic2971.htmhttp://en.wikipedia.org/wiki/EMedicinehttp://en.wikipedia.org/wiki/EMedicinehttp://en.wikipedia.org/wiki/EMedicinehttp://ww5.komen.org/uploadedfiles/Content_Binaries/806-380a.pdfhttp://spotlight%28%27iframe%27%2C%27bsl_kbc/en/kbc_04_02a.htm',760,480);http://spotlight%28%27iframe%27%2C%27bsl_kbc/en/kbc_04_02a.htm',760,480);http://ww5.komen.org/uploadedfiles/Content_Binaries/806-380a.pdfhttp://en.wikipedia.org/wiki/EMedicinehttp://www.emedicine.com/med/topic2971.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003658.htmhttp://en.wikipedia.org/wiki/MedlinePlushttp://www.nlm.nih.gov/medlineplus/ency/article/003899.htmhttp://en.wikipedia.org/wiki/MedlinePlushttp://en.wikipedia.org/wiki/EMedicinehttp://www.emedicine.com/ent/topic561.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003860.htmhttp://en.wikipedia.org/wiki/MedlinePlushttp://en.wikipedia.org/wiki/GPnotebookhttp://www.gpnotebook.co.uk/simplepage.cfm?ID=-462749619http://en.wikipedia.org/wiki/Medical_Subject_Headingshttp://www.nlm.nih.gov/cgi/mesh/2011/MB_cgi?mode=&term=Aspiration+Biopsy,+Fine-Needlehttp://en.wikipedia.org/w/index.php?title=Fine-needle_aspiration&action=edit&section=6http://oncolex.org/en/Breast%20cancer/Procedures/DIAGNOSTICS/Ultralydveiledet%20finnalbiopsi%20bryst?lg=procedurehttp://en.wikipedia.org/wiki/National_Institutes_of_Healthhttp://www.cc.nih.gov/ccc/patient_education/pepubs/needle.pdfhttp://bmj.bmjjournals.com/cgi/content/full/328/7438/507http://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_ref-4http://en.wikipedia.org/wiki/Royal_College_of_Obstetricians_and_Gynaecologistshttp://en.wikipedia.org/wiki/Royal_College_of_Obstetricians_and_Gynaecologistshttp://www.rcog.org.uk/womens-health/clinical-guidance/chorionic-villus-sampling-cvs-what-you-need-knowhttp://en.wikipedia.org/wiki/Fine-needle_aspiration#cite_ref-3


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Fine needle aspiration (also known as fine needle biopsy) removes cells from a suspicious lump in the breast. The needle used is

thinner than incore needle biopsy. Fine needle aspiration is only used for lumps that can be felt (palpable masses).

The procedure can be done in your health care provider's office. Although core needle biopsy is most often the first choice for

palpable masses, fine needle aspiration is sometimes done as a quick way to sample a breast lump felt during aclinical breast

exam.

Before the procedure, your provider may use a small amount oflocal anesthetic to numb the area. He/she will then insert theneedle and remove a sample of cells. The whole procedure takes only a few minutes.

Advantages of fine needle aspiration

Fine needle aspiration is accurate when done by an experienced provider and read by an experiencedcytopathologist(a physician

who specializes in checking cells under a microscope).

The procedure is quick and only mildly uncomfortable. Plus, there is only a small chance of infection or bruising.

If the lump was not thought to be cancer before the biopsy, abenign test result means you will likely not need asurgical biopsy.

Drawbacks of fine needle aspiration

One drawback of fine needle aspiration is that the needle can miss a tumor and take a sample of normal cells instead. If this

happens, the biopsy will show cancer does not exist when in fact, it does. This is called a false negative result and can delay

diagnosis. When combined with a clinical breast exam and a mammogram, the false negative rate of fine needle aspirations of

lumps that can be felt is about five percent [5].

Sometimes, even if the correct area is sampled, the procedure may not remove enough cells to be able to tell if they contain

cancer. So, a fine needle aspiration that does not find cancer may need to be followed up with acore needle biopsy or asurgical

biopsy.

Another drawback of fine needle aspiration is that the cell samples give limited information about the tumor. For example, they

often cannot tell whether a tumorisductal carcinoma in situ orinvasive breast cancer. The cells removed by fine needle aspiration

must also be checked by an experienced breastcytopathologist, and not all hospitals have a cytopathologist.

Updated 10/29/12
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Biopsy for Breast Cancer Diagnosis

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