Life After Mastectomy

breast FNA

Going for breast FNA? Chances are, you’re fine.

A breast FNA, or fine-needle aspiration biopsy (FNAB) is an often-used diagnostic procedure.  It’s used for gathering helpful information from unidentified lumps in the breast.  FNAB has a host of advantages when diagnosing issues in the head and neck but can be used in many areas of the human body.  It’s commonly talked about when investigating thyroid nodules (lumps) and breast lumps.  So, if you have a lump in your breast and it’s being ‘checked out’, this is a good thing.  It’s relatively quick, easy, and has a really high chance of telling your medical team whether your lump is of concern, or not.  That is, the accuracy is pretty reliable. So, do not go straight to panic if you are told you need a FNA breast biopsy!

What is a breast FNA or FNA breast biopsy?

A biopsy is a procedure that takes a small sample of tissue from an area of concern, such as a breast lump.  The sample of tissue is then analysed to determine what it is composed of.  That is, something harmful, or not.  It’s often the only reliable way to identify a lump.

A fine-needle aspiration biopsy uses a very fine needle and syringe arrangement to extract tissue from the area of concern.  In the context of this article, that’s the breast lump.  The needle and syringe aren’t too dissimilaar from the type used for taking blood samples.  FNAB is the least invasive of all biopsy types, as such a tiny amount of skin is disturbed.  It is ‘invasive’, though, as the skin and body are, well, invaded.  But, it’s really a favorable way to get a pretty reliable indication of what’s going on.  An FNAB doesn’t even scar.  Of course, check your medical specialist’s advice on this, but for most people, visible scaring would be highly unlikely.

The procedure is also referred to as a fine-needle biopsy or FNA.  Some people may also call it a fna breast biopsy.

In short, a FNA breast biopsy will be quick, easy and relatively painless.  In addition it’s also relatively reliable in letting your medical specialist determine whether a lump in your breast or related chest area is of concern, or not.

How is a breast FNA or FNA breast biopsy performed?

As it’s such a commonly used and minimally invasive procedure, hospitalization is unlikely.  Outpatient clinics and specialist diagnostic centers are well able to provide these services expertly.  What is available to you will probably come down to a few factors.  Where you live, your medical specialist’s preferences and your health cover options to name the obvious ones.  However, if you’re in a ‘first world country’, you’re likely to be well looked after.  [Note: Having said you’ll be well looked after, I recommend always taking responsibility for your care to hold your medical team accountable.  Please see my article HERE for some considerations]

In my personal experience, a FNA breast biopsy is ‘image-guided’.  Otherwise known as ultrasound guided fine needle aspiration.  That is, ultrasound is used to view the needle as it is inserted into the lump.  If you’re not squeamish and can see the screen, it’s rather fascinating.  The ultrasound probe will ensure the needle takes a suitable biopsy, which may require several passes.  The needle may be inserted into the lump several times to ensure sufficient tissue is extracted.  It’s important to get sufficient good tissue samples to get the most comprehensive pathology results.

The doctor will numb the biopsy site with a topical or injectable anaesthetic.  Pain is unlikely to be an issue with this type of procedure, but do discuss this with your doctor.

The FNAB is generally not a long procedure.

breast FNA

When is breast FNA prescribed?

If you have found a lump in your breast or chest area during self-examination (link), which of course WE ALL DO MONTLY, it needs to be identified to rule out cancer.  If your doctor locates a lump during examination – same.

Generally, though, and if there’s evidence to suggest the lump may be a simple cyst, an ultrasound and/or mammogram may be the first port of call.  However, if not conclusive, the breast FNA is the next level of investigation.  The breast FNA can gather more or different/additional information than/to an ultrasound and mammogram.

However, the next level up from the FNAB is a core biopsy (link) which takes more material.  So, it is more invasive.  Having said that, scarring and side effects are still (in general) minimal.  It’s still a small procedure, relatively speaking. In theory, a core biopsy provides more information from a larger sample of tissue, to ideally provide a definitive answer.

The ‘triple test’

Self-examination comes first, then mammogram and/or ultrasound comes next.  When more information is desired, and breast FNA is utilized, this gives you the ‘triple test’.  Your doctor/s and medical care team will interpret the information from these results.  Breast FNA diagnostics are reported as good, but they are not 100% accurate.  If there is any doubt left in your doctor’s mind, they will generally take the next step.  The next step is the core biopsy to take a larger sample for analysis.

However, often the ‘triple test’ gives sufficient information.  The ‘triple test’ can determine that your breast lump is not identified as cancerous. Then, no further diagnostic action is required, except to monitor the lump.  And, of course, continue with monthly breast self-examination.

How to prepare for a breast FNA

Preparation is minimal for a breast FNA diagnostic procedure.  It may even be done in the same consultation as other services. When you’re having a mammogram and/or ultrasound for your breast health check is a logical time.

Whilst an anaesthetic is used, breast FNA can be uncomfortable and may be a little painful for some.  You’ll have to remove garments from your upper body to access the test area.  So a top and pants/skirt is a good idea.  Don’t do what I inadvertently did once and wear a dress to an upper body examination appointment.  I felt so awkward I needed to ask if they had a gown I could use!  Generally, though, gowns or a towel covering is available for modesty during the procedure.

Risks or Side Effects of breast FNA

The downsides and potential risks of breast FNA are very small and uncommon.  However, your doctor should always discuss all aspects of any procedure with you.  If you have any concerns, be sure to ask as many questions as you need to.  In the scheme of things, submitting to a test like breast FNA to investigate a breast lump is a simple and effective action to take.

Breast FNA and breast cancer

Chances are the results will be favorable, because there are many reasons for lumps and bumps in the body.  Not all of them are breast cancer.  Do keep this in mind and don’t allow your mind to go straight to full emergency!  Even if an issue is found, keeping calm, keeping perspective and remaining optimistic will be more productive. In all likelihood, you will be fine.  I do wish this for you.  If you have challenges lying ahead, you are not alone and people do care.