What is fine needle aspiration for breast biopsy?

After a breast lump is found, more tests are done to determine what the lump is and whether it is cancerous. Fine needle aspiration (FNA) is a procedure used to obtain a sample of cells from a breast lump. The results help determine whether it is a cyst, infection, benign tumor or cancer.

FNA is usually chosen when the mass is likely to be a fluid-filled cyst. This is because the procedure is particularly helpful in distinguishing cysts from solid masses. Your healthcare provider will use a very thin needle (much smaller than a lancet) to draw some fluid, and a pathologist will examine it under a microscope.

This article will review FNA in detail and review the situations you may encounter while doing FNA.

Testing purposes

It is wise to check for any breast lumps. Fine needle aspiration may seem scary, but it is a safe, secondary procedure that can provide clear information about a potentially suspicious mass.

If the lump turns into a cyst — a harmless, fluid-filled sac — it can drain the fluid at the same time, relieving any pressure it may have caused.

About 80 percent of breast lumps are not cancerous, but a small percentage of them are malignant. In either case, an examination of the aspirate can provide your healthcare provider with enough information to determine what steps to take next.

According to the American Cancer Society, FNA has two main advantages: First, there is no need to cut the skin, so no stitches are required, and no scarring. Another is that, in some cases, a diagnosis can be made on the same day.

Is this breast lump benign or cancerous?

Risks and Contraindications

The risk of FNA is minimal. There is a possibility of minor bleeding and infection at the injection site. You may experience pain for a day or two after the procedure, along with minor bruising and swelling.

before testing

You do not need to prepare for fine needle aspiration, but it may be helpful to know the following information before surgery.

timing

It takes about 10 to 20 seconds to acquire each sample, and multiple samples may be drawn. The entire process from start to finish usually takes no more than half an hour, but you should allow time to fill out the form and wait in the office.

You can get your results two to three days after the test, possibly earlier.

Place

Fine needle aspiration is an outpatient procedure performed at a healthcare provider’s office or medical clinic with professionals trained in the technique and access to a pathology laboratory that can examine the collected fluid.

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Biopsies are usually performed in a radiology department if ultrasound guidance is required. The machine uses high-frequency sound waves to provide a continuous image of the mass, allowing healthcare providers to accurately direct the needle to the correct location.

diet

You can eat normally before surgery. Ask your healthcare provider if you should stop taking any medications, such as blood thinners, before surgery.

Fees and Health Insurance

Most private insurance companies, as well as Medicare, will pay for a breast biopsy when needed. For some insurance companies, or to recommend special technology, you may need prior authorization.

Other considerations

You won’t sleep during FNA, so you’ll be able to get on with your life after the procedure – back to work, caring for your family, driving.

During the test

You will interact with the doctor who performs the fine needle aspiration, but not the pathologist who will examine the sample and ultimately provide the results to your provider.

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You will undress from the waist up and wear a robe that opens in the front. After changing and before the procedure begins, your healthcare provider will ask you if you have any questions. You will also be asked to sign an informed consent form indicating that you understand the purpose of the procedure and any potential risks.

You will be awake and lying on your back during the procedure. Your skin will be wiped with an antiseptic solution to prevent infection.

You can ask for a local anesthetic to numb the area of ​​the breast where the needle will go, but the needle used for FNA is so thin that the anesthetic may cause more damage than the biopsy itself.

throughout the test

Your healthcare provider will locate the lump by feeling it or looking at it using an ultrasound. They will then immobilize the lump and use a very thin needle to pierce it and draw out the fluid with a syringe. If using an ultrasound, you may feel some pressure from the rod as you insert the needle.

If no fluid comes out, the healthcare provider may reposition the needle and try again.

after test

After capturing the fluid, remove the needle, apply pressure to prevent bruising, and use a bandage to cover the site.

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after test

Fine needle aspiration has few apparent complications when performed by an experienced practitioner.

The most common is mild bruising, tenderness, or swelling in the area a few days after surgery. These can be relieved with over-the-counter pain relievers like Tylenol (acetaminophen) and a short cold compress.

Call your healthcare provider if you have persistent swelling or bleeding, a fever over 101 degrees Fahrenheit, and/or persistent pain.

Interpret the results

A doctor, a specially trained pathologist, will examine the biopsy fluid or tissue to see if it contains cancer cells. Test results can take up to two to three days, but sometimes they are available on the same day. The pathology report will be sent to your healthcare provider, who will either call or let you in to get the results.

  • A normal result means there are no signs of cancer or other breast problems.
  • Abnormal results do not mean you have cancer or precancerous lesions, but could be any number of benign breast conditions, including fibroadenoma or fat necrosis.

The color of the fluid drawn from the lump during surgery will give some clues about its nature:

  • If the fluid is brown, green, or tan, and the lump shrinks with suction, it’s most likely a cyst.
  • Sometimes the fluid is clear or bloody, and in rare cases, this means the lump is cancerous.
  • If the needle draws out a small amount of tissue and very little fluid, it indicates a solid mass.

Needle aspiration is 80% to 85% accurate in clearly indicating whether a breast mass is a cyst or a solid breast mass. But sometimes, the results don’t give a definitive diagnosis.

Fine needle aspiration may drain the cyst, causing the mass to disappear. This is a good indication that the lump is not cancerous. However, some cysts do refill and can be surgically removed if they become troublesome.

follow up

The pathology report will help you and your healthcare provider discuss next steps, if any. If your healthcare provider still has concerns for some reason, they may recommend another FNA or other type of biopsy, such as:

  • Core needle biopsy: This requires using a larger needle than a fine needle biopsy and removing a small cylinder (“core”) of tissue, not a collection of cells. Ultrasound or magnetic resonance imaging (MRI) is usually used to help locate the correct area for biopsy.
  • stereotaxic Biopsy: With this method, a 3D image of the breast is made using a computer and mammogram results. The 3D image then guides the biopsy needle to the exact location of the breast lump.
  • Open (surgical) biopsy: This type of biopsy may be incisional (including removal of part of the abnormality) or excisional (removal of all abnormalities).
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Overview of Breast Biopsy

In the case of breast cancer, you may be referred to a breast cancer specialist, who may recommend more scans, laboratory tests, or surgery. Your medical team will use the results of the pathology report and other tests to determine the stage of the cancer and design the best treatment plan for you.

generalize

It can be disconcerting to hear that you need a biopsy to get more information about a breast lump. But fine needle aspiration is minimally invasive and can provide valuable information about the mass. It is a short process with few side effects and can be done easily. Discuss with your healthcare provider any questions or concerns you may have about the procedure or expected results.

VigorTip words

Taking, waiting, and receiving test results can trigger anxiety. But keep in mind that 80% of women who have a breast biopsy do not develop breast cancer. Even if cancer is found, most of these cancers will be early-stage tumors.

Treatment for these cases has improved, and the new options have significantly reduced the risk of recurrence and are generally much less invasive than older methods. As for metastatic cases, present in less than 5% of women at diagnosis, treatment is improving and life expectancy is increasing.

Frequently Asked Questions

  • Is fine needle aspiration only used for breast biopsy?

    Can not. Fine needle aspiration can be used anywhere on the body. It is most commonly used on breasts, thyroid, suspicious lymph nodes, or skin lumps.

  • Is breast fine needle aspiration painful?

    Should not. The needles are thin, cause little (if any) pain, and usually don’t even require local anesthesia.

  • Is fine needle aspiration the same as biopsy?

    Yes, this is a type of biopsy. In a biopsy, cells, fluids, or tissue are removed and examined. In FNA, fluid and cells are removed through a needle and subsequently examined.

  • What percentage of biopsies are cancer?

    About 20% of breast biopsies turn out to be cancer. This means that the vast majority of breast cancer biopsies do not find cancer. This helps to remember if you are feeling anxious.