Previous section | Next section

Breast fine‐needle aspiration (FNA)

Rationale

Fine‐needle aspiration will provide cells for cytological assessment rather than a block of tissue. As the information available from cytology is less detailed, a biopsy is considered the best approach. However, FNA is performed if the lesion is positioned in such a way that a biopsy may be more hazardous to the patient. An FNA is also the standard pathological investigation for initial assessment of a lymph node. Standard cytological assessment will confirm whether cells are benign or malignant and this is satisfactory for benign outcomes.

Indications

FNA is the second choice for obtaining a pathological sample. It is indicated in the following situations:

Where the presenting lesion is considered to be a lymph node rather than a breast lesion.
Where the index lesion is located in a technically difficult area to biopsy.
Where the biopsy may carry more risk.
Where the area to be assessed is below the size suitable for a core biopsy.
If the patient is on anticoagulant therapy with INR outside of range (> 4) and said therapy cannot be stopped (BSBR [20]). Patients undergoing an FNA do not need to have INR checked or therapy stopped.

Contraindications

Position and location of lesion that is inaccessible with FNA.

Procedure guideline 20.10