However, please allow an hour for your visit because of registration and possible waiting time in the office. Continue reading. Generally, your results should be available from your surgeon's office in two to three working days. The results can be grouped into three categories:. In the hands of a skilled FNA practitioner, this test is very reliable. In the instance of a clearly benign diagnosis, it may prevent you from undergoing surgery.
In the case of a clearly malignant diagnosis, it quickly establishes the need for further treatment. In the less frequent occurrence of a non-definitive diagnosis, either repetition of the FNA or a surgical biopsy is usually recommended.
Our experience at UCSF Medical Center has demonstrated a 2 percent to 3 percent chance that a cancer may not be detected. This is why you will be asked to come back for a follow-up visit. We also take into account the result of any imaging studies, such as a mammogram or ultrasound scan, and how the lump feels to your doctor.
By doing this, the chance of missing a cancer is reduced to less than 1 percent. When carried out by an experienced practitioner, a fine needle aspiration biopsy is virtually free of significant complications. The most common complication is a slight bruising or tenderness of the area for a few days following the procedure.
Discomfort should be relieved by an over-the-counter pain reliever such as Tylenol or the application of an icepack for short periods following your return home. Please call the Breast Care Center immediately if you experience any of the following symptoms after your biopsy:. UCSF Health medical specialists have reviewed this information.
There are generally no complications with this procedure, though you may experience some tenderness or bruising over the needle insertion site. If you experience any bleeding, swelling, fever or pain that is not relieved with paracetamol, contact your doctor immediately. It is not recommended that you use aspirin to relive pain as it may worsen any bruising. The samples taken are examined by a pathologist under a microscope.
A detailed report will then be provided about the type of cells that were seen, including any suggestion that the cells might be cancer.
It is important to remember that having a lump or mass does not necessarily mean that it is cancerous; many fine needle aspiration biopsies reveal that suspicious lumps or masses are benign non-cancerous or cysts.
Aspirate samples may be described as one of the following types:. A fine needle biopsy is an effective tool in evaluating and diagnosing suspect lumps or masses. A quick diagnosis can mean that cancer is detected early, giving more options for treatment, or that benign lumps are diagnosed without the need for surgery. It is non-invasive and only slightly uncomfortable, compared to a surgical biopsy which requires a general anaesthetic, involves pain and the possibility of infection or scarring.
Fine needle aspiration biopsies do require some expertise to perform and interpret. To ensure that an accurate result is achieved, it is important that the general practitioner, radiologist, surgeon, pathologist or oncologist who performs your procedure has experience in fine needle aspiration biopsy. A fine needle biopsy is a quick and effective test for determining the status of suspect tissue. Compared to a surgical biopsy, fine needle aspiration biopsy involves little possibility of scarring, infection or pain, and has a significantly shorter recovery time.
It is also extremely useful in the diagnosis and treatment of cysts. The risks of fine needle aspiration biopsy include the possibility of cancer cells being trailed into unaffected tissue as the needle is removed, but this is rare when the test is performed by skilled practitioners.
Because an FNA biopsy can only sample a small number of cells from a mass or lump, there is a risk that any abnormal cells may be missed and not detected.
This may mean that a larger sample must be taken, for example by core needle biopsy. It is sometimes used instead of fine needle aspiration biopsy, or vice versa. Core biopsy is a more invasive procedure than FNA, as it involves making a small incision cut in the skin.
A large needle is then passed through this incision and several narrow samples of the tissue to be investigated such as a lump are taken. As with fine needle aspiration, ultrasound or mammographic guidance may be needed to locate the lump or area to be sampled. Core biopsy is done under local anaesthetic. The procedure usually takes between 30 minutes and 1 hour. After the procedure, the biopsy area will be covered with a simple dressing.
A core biopsy may result in a small, very fine scar where the incision was made. The samples of tissue taken during a core biopsy differ from those taken during FNA. Because the cells from a fine needle aspiration biopsy are sucked up randomly into the needle, they are seen under the microscope as a disorganised jumble of cells see the image at right.
We have an entire page on symptoms caused by thyroid nodules. FNA biopsies should be done on any swollen or abnormal lymph nodes in the neck.
This may be more accurate in diagnosing thyroid cancer than FNA of the thyroid nodule itself! FNA biopsy should be done on thyroid nodules that have a certain characteristic under the ultrasound. Almost always by an endocrinologist or a radiologist with expertise in FNA biopsy.
Before the FNA biopsy, local anesthesia numbing medicine is injected into the skin over the thyroid nodule. Ultrasound will be used so the doctor can see the nodule or lymph node. They can see the needle going into the nodule. Your doctor will place a thin, hollow needle directly into the nodule to aspirate take out some cells and possibly a few drops of fluid into a syringe.
The doctor usually repeats this 2 or 3 more times, taking samples from several areas of the nodule. The content of the needle and syringe are then placed on a glass slide and then the FNA samples are then sent to a lab, where they are looked at under a microscope by the expert Cytologist to see if the cells look cancerous or benign.
Cytology means looking at just the cells under the microscope. Thyroid cytology requires an expert physician called a Cytologist trained specifically in the diagnosis of thyroid nodules and thyroid cancers! This picture shows a cytology slide of an FNA needle biopsy of a thyroid nodule.
They then squirt the content of the syringe onto a glass microscope slide which then has some special dyes put on it to color different parts of the cells. This slide shows lots of cells and is a very good slide. They can't tell if it's cancer if they don't have enough cells. The cytologist looks at the size and shape of the cells. They look at the dark material in the center of the cell--this is the DNA within the nucleus or center of the thyroid cell.
This clearing of the nucleus means this FNA biopsy is suspicious for a diagnosis of papillary thyroid cancer. Does FNA biopsy always work? Does FNA needle biopsy of the thyroid always tell cancer of the thyroid? FNA needle biopsy of thyroid nodules is a very reliable test that works great in most cases.
It is very important for you to chose the most experienced doctor you can. Find an expert so you don't waste your time and you get the most accurate information! Experience counts! The diagnosis of thyroid cancer by FNA biopsy are frequently misinterpreted by unskilled or inexperienced Cytologists.
The guy looking into the microscope needs to be experience too because they can get it wrong! Bleeding at the FNA biopsy site is very rare except in people with bleeding disorders. Even when this occurs, the bleeding is almost always very self limited. Be sure to tell your doctor if you have problems with bleeding or are taking medicines that could affect bleeding, such as aspirin or blood thinners. This is called an "inadequate specimen", meaning the needle didn't suck up enough cells for the cytologist to look at under the microscope.
Most FNA thyroid biopsies will show that the thyroid nodule is benign, because, most thyroid nodules are benign non-cancerous. Rarely, the FNA thyroid biopsy may come back as benign even though a diagnosis of a thyroid cancer is actually present. In other words, it is possible but quite rare for the nodule to be cancerous but the result of the cytology report is that no cancer is present benign. When this happens, the decisions made should be just like the diagnosis of papillary thyroid cancer is made.
In other words, if the FNA results say "suspicious for cancer" then we treat it like it is cancer. Suspicious for cancer is treated the same as if it was diagnosed as cancer.
The pathologist looks at the cells and just can't be sure if it is cancer, or non-cancer benign. If this happens, an option that your doctor has is to genetic testing done on the cells of the biopsy to see if there are genetic abnormalities seen.
There are several commercially available tests that doctors can send the samples to determine the risk of the cells being cancerous--they look for several specific abnormal pieces of DNA that are frequently associated with thyroid cancer.
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