How is fine needle aspiration (FNA) performed in the workup of breast lesions?

Updated: Aug 09, 2018
  • Author: Hemant Singhal, MD, MBBS, MBA, FRCS, FRCS(Edin), FRCSC; Chief Editor: Meda Raghavendra (Raghu), MD  more...
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Answer

Answer

To perform FNA, the skin should be disinfected with an alcohol wipe, and the needle is passed through the lesion a number of times, while maintaining suction and steadying the breast tissue with the other hand. Appreciating the potential risk of pneumothorax is important when performing needle biopsies of the breast, and wherever possible, the needle should be angled tangentially to the chest wall. Continue sampling until aspirate is observed at the bottom of the plastic portion of the needle.

Transfer the aspirate to slides. Spread the aspirate thin enough to visualize individual cells. The slides may be air-dried or fixed according to the preference of the local laboratory. Cytospin preparations of the aspirate may allow a greater number of slides to be made.

A cytologist then examines the slide. The success of FNA biopsy is highly dependent on the expertise of the cytologist, as well as on accurate localization.


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