The Who, What, Where, When and Sometimes, Why.

Fine Needle Aspiration (Fine Needle Biopsy)

Fine needle aspiration (also called fine needle biopsy) removes cells from a suspicious lump in the breast. The needle used is thinner than in core needle biopsy.

Fine needle aspiration is only used for lumps that can be felt (palpable masses).

Core needle biopsy is the standard and preferred way to biopsy palpable masses. However, fine needle aspiration is sometimes done as a quick way to sample a breast lump or suspicious lymph nodes in the underarm area.

Learn more about types of biopsies.

The procedure

A fine needle aspiration can be done in your health care provider’s office.

Before the procedure, your health care provider may use a small amount of local anesthetic to numb the area.

Your health care provider will then insert the needle and remove a sample of cells.

The whole process only takes a few minutes.

Advantages of fine needle aspiration

Fine needle aspiration is accurate when done by an experienced health care provider and read by an experienced cytopathologist (a doctor who specializes in checking individual cells under a microscope).

The procedure is less invasive than a core needle biopsy and the chance of infection or bruising is very small.

Drawbacks of fine needle aspiration

One important drawback of fine needle aspiration is the cell samples give limited information about the tumor. For example, the pathologist often can’t tell whether a tumor is non-invasive breast cancer (ductal carcinoma in situ) or invasive breast cancer from the samples.

Another drawback of fine needle aspiration is the needle can miss a tumor and take a sample of normal cells instead.

If this happens, the biopsy will show cancer doesn’t exist when in fact, it does. This is called a false negative result and delays diagnosis. The false negative rate of fine needle aspirations of lumps that can be felt is low, about 2-4 percent [6,9-10].

Sometimes, even if the correct area is sampled, not enough cells are removed to be able to tell if there’s cancer. So, a fine needle aspiration that doesn’t find cancer may need to be followed up with a core needle biopsy or a surgical biopsy.

The cells removed by fine needle aspiration must also be checked by an experienced breast cytopathologist, and not all hospitals have one. 

Updated 11/12/21

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