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Fine Needle Aspiration (FNA)

This is a fairly easy and well tolerated procedure. It is most commonly done as outpatient. Normally there is no need for sedation. A very thin and fine needle is inserted into the tumor site and cells are extracted for laboratory studies. If a tumor is visible or easily palpable, FNA could be done in a matter of minutes. For tumors that are located in deep areas, the procedure is normally done under indirect visualization of the tumor site with CT Scan or Ultrasound.

The material that is obtained shall be sent to a pathologist who has experience in studying and interpreting the needle aspiration material. Further work up will depend on the results of this test.  There are few possibilities:

Inadequate sample.  Since FNA is a done rather blindly and a needle is placed in an area that is thought to be a tumor site, physician may have not obtained sufficient amount of material for a pathological review.   This kind of result does not prove or disprove a diagnosis and one has to repeat the FNA again.

Adequate sample, Negative test result/ Sampling of the breast lump has been successful, yet no cancer was seen in the material that was obtained.  A negative test, although encouraging, but does not completely rule out possibility of existence of a cancer.  The needle may have sampled non-cancer containing tissues in the breast.  Depending on the clinical situation, size of the lump, age of the patient and mammogram findings, the physician shall make a decision as to repeating the FNA or proceeding with another procedure to obtain more tissue from the lump.

Positive Test result, cancer cells seen.  In this case a diagnosis of cancer is established and the physician shall plan for a treatment strategy.