Fine Needle Aspiration Biopsy (FNA)

First, the skin of the breast is cleaned. If a breast lump can be felt, the radiologist or surgeon will guide a needle into the area of concern by palpating (feeling) the lump. If the lump cannot be felt, the FNA procedure will be done under image-guidance using either stereotactic mammography or ultrasound with the patient in either the upright or prone (face down) position. Stereotactic mammography involves using computers to pinpoint the exact location of a breast mass based on mammograms (x-rays) taken from two different angles. The computer coordinates will help the physician to guide the needle to the correct area in the breast. With ultrasound, the radiologist or surgeon will watch the needle on the ultrasound monitor to help guide it to the area of concern. FNA is usually performed under ultrasound image guidance.  After the needle is placed into the breast in the region of the lesion (abnormality), a vacuum is created and multiple in and out needle motions are performed. Several needle insertions are usually required to ensure that an adequate tissue sample is taken. The samples are then smeared on a microscope slide and examined by a pathologist under the microscope. FNA does not require stitches and can usually be performed on an outpatient basis. A very small bandage is placed over the area after the procedure. Many patients resume their normal lifestyle and routine the same day of the FNA procedure.