In this type of breast biopsy, a needle is used to aspirate (draw out) fluid or tissue from a breast lump. Needle aspiration leaves no scarring, is less invasive and quicker than open excisional biopsy, and usually does not require stitches or a recovery period. The patient can resume regular activities immediately.
Techniques
Needle aspiration procedures include the following:
- Fine needle aspiration
- Core needle biopsy
- Vacuum-assisted biopsy
- Large core biopsy
Each procedure differs in how it is performed, the equipment used, the type of lesion it works best on, and the amount of tissue it removes. Unlike surgical biopsy, needle aspiration cannot remove the entire lesion and misdiagnosis can occur.
Fine Needle Aspiration
This procedure is performed under local anesthesia. The surgeon uses a fine hollow needle that is attached to a syringe to extract fluid from a cyst or cells from a solid lesion. The needle used in this procedure is very small (smaller than those used to draw blood). Several insertions are usually required to obtain an adequate sample. The procedure takes a few minutes and is often done in a doctor's office.
If the lump cannot be felt, ultrasound may be utilized to help the physician guide the needle into the breast and to the lesion. Stereotactic mammography may also be used. This mammography utilizes a computer to pinpoint the mass or cyst. Mammograms are taken from two angles and the computer maps the precise location of the lesion.
There is no incision and a very small bandage is put over the site where the needle entered. Fine needle aspiration is the easiest and fastest method of obtaining a breast biopsy, and is very effective for women who have fluid filled cysts. However, the pathological evaluation can be incomplete because the tissue sample is very small. When used alone, about 10% of breast cancers may be missed. The effectiveness of this procedure depends on the skill of the surgeon or radiologist who performs it.
Core needle biopsy
This procedure is similar to fine needle aspiration, but the needle is larger, enabling a larger sample to be obtained. It is performed under local anesthesia and ultrasound or stereotactic mammography is used if the lump cannot be felt.
Three to six needle insertions are needed to obtain an adequate sample of tissue. A clicking sound may be heard as the samples are being taken and the patient may feel some pressure, but should not feel pain. The procedure takes a few minutes and no stitches are required.
Core needle biopsy may provide a more accurate analysis and diagnosis than fine needle aspiration because tissue is removed, rather than just cells. This procedure is not accurate in patients with very small or hard lumps.
Vacuum-assisted biopsy
This method utilizes a vacuum-like device to remove breast tissue. Local anesthesia is used and no incision is made. Stereot...
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