Fine Needle Breast Cytology (FNAC Breast Biopsy)

The breast biopsy is used to determine whether or not a worrisome abnormality or area of calcification is cancer and, if it is cancer, what type it is and how to develop a treatment plan. When no breast cancer is detected, the diagnosis of a benign or harmless lump is reassuring. The percentage of breast biopsies that are positive for cancer varies according to the individual hospital or clinic, but in general, only about 20% of breast lumps are cancerous. The majority of breast biopsies do not detect cancer.

Except for a minor sting from the injected anaesthesia, patients usually feel no pain before or during a procedure.

The risk of complications, such as infection and bleeding, is small for nonsurgical procedures and slightly higher for surgical procedures.

A fine needle aspiration biopsy can be done in several different ways:

• Fine-needle aspiration (FNA) for palpable growths: A palpable growth is one that can be felt. The patient usually sits up while the doctor inserts a small hollow needle with a syringe to withdraw (aspirate) fluid and cells from the growth for testing. The doctor simply feels (palpates) the suspicious area of the breast and inserts the needle into the site. When the needle reaches the mass, the doctor suctions out a sample with the syringe. The doctor repeats this procedure several times. If the mass is a cyst, the withdrawn samples will consist mainly of fluid and the cyst may collapse, relieving any pain the patient feels. If the mass is solid, the samples will consist primarily of tissue cells.By analyzing the samples immediately after their withdrawal, a doctor may be able to determine that they came from a cyst and simply discard them, diagnosing the growth as benign. In all other cases, fluid and tissue samples are placed on slides and then analyzed by a pathologist in a laboratory. Atypical cells found in a fine-needle aspiration biopsy may signal that cancer is present or that repeat biopsies are necessary.

Guided FNA for non-palpable growths: When a growth is too small or deep to palpate (feel), the doctor must locate it with one of several imaging techniques. First, the patient lies face-down on a table with the breasts suspended through an opening. With stereotactic mammography, mammograms of the suspicious breast site are taken from different angles to form a virtual three-dimensional (stereotactic) image that precisely pinpoints the location of the suspicious area. The computer then uses a motor to guide a small hollow needle to the site to remove the samples. The withdrawn samples are then analyzed for the presence of cancer. Ultrasound and MRI are other imaging techniques that may be used to guide breast biopsies.

After a procedure, some patients may experience some soreness and pain as well as bruising and minor skin discolouration of the breast that usually resolves within a week or so. Usually, an over-the-counter drug such as acetaminophen (Tylenol) is sufficient to alleviate any discomfort.

For small biopsies and fine-needle aspirations, the results may be available the next day. The results of most breast biopsies will be available within a few days. Sometimes special testing must be performed, and the results may be delayed and take longer. This does not necessarily mean that a cancer is present. For example, sometimes the tissue sections must be recut to reveal deeper layers of the tissue to allow for an optimal evaluation by the pathologist. In other cases, special tissue stains may be necessary to help the pathologist assess the tissue sample under the microscope. The radiologist or surgeon performing the procedure will be able to give you a better idea of the approximate time frame and how the result will be communicated to you.