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What is a fine needle aspiration (FNA)?
Fine Needle Aspiration is a method of taking a small amount of tissue from a lump in the body. A very thin needle is inserted into the lump and tissue is dislodged by movement of the needle and/or by gentle suction. The tissue is then examined microscopically by a pathologist. The pathologist will make a diagnosis (find out the cause of the lump) and send a report to your doctor.

Is FNA painful?
No, the procedure is completely painless. However, the needles used in FNA are very thin. Also, for your comfort, local anesthesia is often used before the FNA. If you are sore after the procedure, a simple pain reliever such as Tylenol (no nonsteroidal anti-inflammatories, i.e. Advil) or an ice pack may alleviate mild symptoms.

How accurate is FNA?
Most doctors consider FNA to be a very good test. Overall, it is about 90-95% accurate when the aspiration and interpretation are done by an experienced cytopathologist. There is a small chance (usually less than 10%, depending on the size, location and nature of the lump) that the FNA will not be interpreted as cancer when cancer is there. Very rarely (usually less than 1% of the cases), FNA may be falsely interpreted as cancer when cancer is not there. Your doctor will use the results of the FNA and other clinical information to determine if further tests or treatment are necessary.

What are the risks of FNA?
As with any procedure in which the skin is broken (like having your blood drawn), there is always a risk of pain, bleeding, bruising or slight tenderness at the aspiration site. Very rarely, an infection may occur after an FNA. However, the benefits of the FNA far outweigh the risks.

What are the alternatives to FNA?
The alternative is to do a surgical biopsy, which is done with a much larger needle or by an operation. Surgery is more invasive, has more complications, and may take a while to schedule. An FNA is simpler, less expensive, has fewer complications and faster.

Is there any preparation for the FNA?
Generally, you may engage in your normal activities, including eating and drinking before and after the procedure. The only special precaution is to avoid taking anything that would increase bleeding such as aspirin or non-steroidal anti-inflammatories (NSAIDs), such as Advil, Ibuprofen, Motrin, Alieve, fish oil, vitamin E, etc., from about a week before the appointment (or the time your appointment is made), to a few days after the procedure. This may be helpful in limiting any additional bruising from the procedure. Moreover, you may resume normal activities immediately after the procedure.

How long does the procedure take?
Depending on what type of lesion (lump) it is and where it is in the body, the actual biopsy takes only a few minutes. However, since the FNA is being performed by a cytopathologist, (Dr. Nadelman), the material is checked immediately under the microscope as you wait, to ensure that there is enough material to make a diagnosis later on. This is done to decrease the chance of having to come back for a repeat FNA because of not enough material. Due to this, the procedure may take up to 45 minutes (per site).

How long will it take to get my results?
After the biopsy sample has been obtained and you have left the office, all the slides prepared will be thoroughly examined and interpreted by the cytopathologist, Dr. Nadelman. A preliminary report can be telephoned to your doctor shortly after the FNA procedure (often within 24 hours). Because of the detailed evaluation involved and the possibility of additional studies, a final written report may require a few days (2-4 days) to complete, but is usually done in 48 hours. Fine Needle Aspiration (FNA) is a diagnostic part of a complete evaluation of the specific site of concern indicated by your referring doctor. Therefore, the results will be given to your doctor and should be discussed with him or her. If you would like to receive your results directly, in addition, you may make a follow up appointment with Dr. Nadelman. Our goal is to care for you in the best, most efficient, yet personalized manner. If you have any further questions please contact us.