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Fine Needle Aspiration and Core Biopsy

Fine Needle Aspiration

A Fine Needle Aspiration (FNA) is an interventional procedure used to acquire a cell sample for pathologic analysis. The specimen is extracted (aspirated) by the insertion of a fine needle (typically smaller than that used to take blood), in the region of interest with cells being acquired through the gentle manipulation of the needle. To ensure accuracy of the sample taken, ultrasound is used by the radiologist to correctly locate and place the needle in the lesion whilst the sample is acquired. Local anesthetic will be first be administered to the region of interest site prior to the acquisition of the first biopsy. For proper analysis to be made by the pathologist once back at the laboratory, multiple samples or ‘passes’ are taken to ensure enough cells are acquired. An on-site cytologist will be present to assess each acquired sample under a microscope, to reduce the likelihood of inconclusive results due to insufficient cell number. Depending on the pathology provider used, result time may vary, however typically they will be available to you referring doctor within 2-3 business days.

What can I expect following the procedure?

Any pain after FNA can be relieved with non-prescription analgesics, such as paracetamol. You should not take aspirin, because this thins the blood and may increase the risk of bleeding and bruising. Minimal bleeding or bruising can appear after the procedure, especially if you are taking anticoagulant medication, aspirin or fish oil. This can be minimised by good compression and the application of an icepack on the skin at the site of the FNA. Breast FNA does not leave a scar on the skin and there is a low risk of infection.

Core Biopsy / Vacuum Assisted Core Biopsies

A core biopsy involves the use of a specified instrument called a ‘core needle’, which is used to acquire tissue samples from a lesion. Following the administration of local anesthetic to the skin a small incision is made (typically less than 5mm) which allows the core needle to be easily advanced through the skin surface to the lesion in question. Once appropriately positioned the core needle is fired through the lesion making an audible ‘click’ as the sample is acquired. Depending on the efficacy of the sample, the process may be repeated multiple times to ensure that suitable samples are obtained for assessment back at the laboratory.
Due to the small incision required in the skin, a fine scar may remain (typically only a few mm) which is likely to fade in time.

What can I expect following the procedure?

Following the core biopsy, you may experience some localised bruising and discomfort which may last for several days. If you require symptomatic relief from any pain experienced you can take non- prescription analgesics, such as paracetamol. To avoid exacerbation of bruising, avoid vigorous exercise for 24 hours post procedure and the use of Aspirin for pain relief due to its blood thinning properties. Ice packs and compression may also be utilised at the biopsy site to relive pain and mitigate any additional bruising.