NEEDLE ASPIRATION BIOPSY
Jerry K. Myers, M.D.
The needle aspiration biopsy is an excellent adjunct to the breast exam in evaluating and carefully following breast problems. It is also utilized to help confirm a malignancy in a suspicious breast mass so that surgical plans can be made prior to an open biopsy.
The procedure is a simple one, done in the office at the same time as the breast exam or ultrasound. It is done by making multiple passes into the breast tissue with a small gauge needle under syringe suction to sample the tissue for cytologic analysis. The procedure cytologically evaluates a piece of tissue as opposed to obtaining a tissue biopsy.
The needle aspirate biopsy is about 95% accurate in the hands of experienced surgeons and pathologists. The only 100% method of diagnosing a breast abnormality is to do an open excisional biopsy.
Once the specimen is taken from the breast, it is placed on a slide, fixed in alcohol, and sent to the pathologist for cytologic evaluation. The tissue is evaluated and a report returned to the office in 2-3 days. Please call the office at that time for the test results – do not expect the results to be called to you. When the report from the pathologist returns, careful follow-up is mandatory if surgery is not recommended. Follow-up on a patient that has a needle aspiration diagnosis is the same as one that is being followed without needle aspiration.
Occasionally, when the aspiration is done, a breast cyst is encountered. This is usually good news if the cyst completely aspirates, since it is rare for a breast cancer to be associated with a breast cyst. If it does not aspirate flat, the residual fullness must be dealt with as one would any other breast nodule.
To summarize, the needle aspirate biopsy is a good tool to aid the breast exam in following and evaluating breast abnormailites. Any suspicious nodule should always be biopsied regardless of the results of the needle aspiration biopsy.