Fineneedle aspiration biopsy

1. Fine-needle aspiration biopsy (FNAB) can be useful in determining if a palpable lump is a simple cyst. To aspirate a palpable, suspected cyst, the mass is stabilized between the fingers and a 22- to 24-gauge needle is inserted with the other hand. Local anesthesia may be used but is not always required.

2. FNAB is especially valuable in evaluating cystic breast lesions and can be therapeutic if all of the fluid is removed. There are three possible scenarios with FNAB:

a. Fluid that is obtained and is not bloody should not be sent for analysis. The mass should disappear and the patient can be checked in four to six weeks to ensure that the cyst has not reappeared; a recurrence suggests the need for surgical referral.

b. Bloody fluid should be sent for pathological analysis; cancer is found in 7 percent of such cases.

3. When no fluid is obtained and the mass turns out to be solid, cells can be obtained for cytologic analysis with FNAB.

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