Minutes

Not months on a waiting list

Results in 24 hours

Preliminary, read in the office

One doctor

Performs it and reads it

No stitches

Local anesthesia only

The procedure

A needle thinner than the one used to draw blood.

Fine needle aspiration is a minimally invasive biopsy that evaluates suspicious lumps, nodules and masses using a thin hollow needle, typically 27 to 23 gauge. It takes minutes, it is done in an outpatient room rather than a surgical suite, and most patients go back to their day immediately afterwards.

Dr. Celina Nadelman performs fine needle aspiration in Los Angeles at her office on South Beverly Drive, minutes from Century City, Beverly Hills, Culver City and Westwood. Patients come in from across the Westside, the South Bay and the San Fernando Valley, and for anyone who cannot travel to the office she makes house calls anywhere in California.

What an FNA involves

  • A needle, not an incision. Nothing to stitch, nothing to heal, and little to no scarring, which matters in visible areas like the neck.
  • Local anesthesia only. No general anesthesia, and none of the risks that come with it.
  • Ultrasound guidance. The needle goes exactly where it is meant to, which is what keeps samples diagnostic.
  • Repeatable if it needs to be. For thyroid nodules under long term monitoring, an FNA can be safely repeated.

What it replaces

  • A surgical biopsy. Which often means a suite, a team, facility fees and a recovery period.
  • A six month wait. Many hospitals and imaging centres schedule biopsies months out. Same day and next day appointments are usually available here.
  • Weeks of laboratory turnaround. The slides are read in the office, so preliminary results usually come within 24 hours.
  • A second procedure. On site evaluation confirms the sample is adequate before you leave.

Cancer cannot wait, and neither should the answer. The point of doing it this way is not convenience. It is that a faster, accurate diagnosis changes what treatment is still available.

How it works

Four steps, one appointment.

Plan on about an hour from walking in to walking out. The step that does not exist elsewhere is the third one.

01

Ultrasound guided imaging

The suspicious area is located on high resolution ultrasound so the needle placement is precise rather than approximate.

02

The aspiration

A thin sterile needle is inserted into the target and a small sample of cells is drawn. Local anesthesia, a few passes, no incision.

03

On site evaluation, or ROSE

Dr. Nadelman evaluates the sample in real time to confirm enough cells were collected. If not, she takes another there and then rather than telling you in two weeks.

04

Cytological diagnosis

The cells undergo detailed cytological examination and preliminary results are typically available within 24 hours, sent to you and to whichever physician you name.

FNA against the alternatives

The difference is who reads your slides.

A traditional biopsy referral can take weeks to schedule and weeks more to process. A radiologist or surgeon takes the sample, and a pathologist you never meet reads it later. Fine needle aspiration performed by a cytopathologist collapses that into one visit.

A surgical or hospital biopsy

Two visits, two specialists, two waits

  • Day 0. Referral and imaging
  • Day 3. A radiologist takes the sample
  • Day 12 to 14. Pathology report reaches your doctor
  • If the sample is short. You find out two weeks later and start over

Weeks, sometimes months

With Dr. Nadelman

One appointment

One visit, one specialist, one answer

  • Day 0. Ultrasound, biopsy, slides read on site, consultation
  • Same day. If the sample is short she knows immediately and takes another
  • Within 24 hours. Preliminary results to you and your doctor
  • No second trip. You talk to the person who made the diagnosis

An answer inside of two days

What FNA can diagnose

A first line diagnostic tool.

Fine needle aspiration is used to evaluate lumps and nodules in the thyroid, breast, lymph nodes and salivary glands, and it can usually tell benign from malignant without surgery.

It is also used for salivary gland lesions, soft tissue masses and cysts, and for suspicious lumps anywhere a needle can reach them under ultrasound. If you are not sure whether what you have is suitable for a fine needle aspiration, that is usually settled in a few minutes on the phone rather than at a second appointment.

Thyroid

Thyroid nodules

Over half of adults develop at least one in their lifetime and most are benign. FNA determines quickly whether a nodule needs anything further, or simply monitoring by ultrasound. Thyroid biopsy

Breast

Breast lumps

A lump can be a benign cyst, a fibroadenoma or a malignancy. FNA gives a fast, reliable answer so treatment planning can start immediately if it is needed. Breast biopsy

Lymph nodes

Lymph node abnormalities

An enlarged node can mean infection, inflammation, metastatic spread from another site, or lymphoma. FNA distinguishes between them. Lymph node biopsy

Celina-M-Nadelman-MD
Why accuracy depends on training

Many doctors can perform an FNA. Few can read one.

An ENT, an endocrinologist, a surgeon or a radiologist can all take the sample. None of them is trained to read the slide, so it goes to a laboratory and someone else makes the diagnosis. Dr. Nadelman is a board certified cytopathologist and fine needle aspiration specialist, which means she performs the biopsy with precision, evaluates it on site in real time, and makes the diagnosis herself. That combination is what reduces false negatives, non-diagnostic samples and repeat procedures.

It is also why patients travel across Los Angeles for a fine needle aspiration rather than taking the first referral they are handed. A biopsy is only as good as the person reading it, and in a city with this many specialists the question worth asking is not who can hold the needle. It is who will be looking down the microscope afterwards.

  • Performs the biopsy with precision, which reduces false negatives and repeat procedures
  • Evaluates the sample immediately on site, so an inadequate sample is caught in minutes
  • Makes the diagnosis herself, avoiding the delay and the handoff of an outside laboratory
  • Arranges molecular testing from the same sample when tumor aggressiveness needs assessing

You have been told you need a biopsy. You do not have to wait months.

Same day and next day appointments are usually available, and house calls are available anywhere in California.

310.702.6701

1125 S. Beverly Drive, Suite 602
Los Angeles, CA 90035
Monday to Friday, 10 to 6

The Los Angeles office. 1125 S. Beverly Drive, Suite 602, Los Angeles, CA 90035. The glass tower on the west side of South Beverly Drive, sixth floor. There is metered parking on the street and a paid garage with the entrance on the south side. From the 10, exit Robertson. Directions and hours, insurances accepted, and what patients ask before booking.

Coming in from outside the city. Patients travel to the Los Angeles office from Beverly Hills, Glendale, Pasadena, Encino, Long Beach and Ventura, and house calls are available anywhere in California. The full list is on service areas.

Before you book

Questions patients ask about FNA.

Does a fine needle aspiration hurt?

Less than most people expect. The needle is thinner than the one used for a blood draw, the area is numbed with local anesthesia first, and there is no incision, so there is nothing to stitch and nothing to heal. Most patients drive themselves home and go back to work the same day.

The aspiration itself takes minutes. Plan on about an hour for the whole appointment, which covers the consultation, the ultrasound, the biopsy, the on site evaluation of the sample and your consultation afterwards.

Preliminary findings are usually available within 24 hours, because the slides are stained and read in the office rather than shipped to an outside laboratory. They go to you and to whichever physician you name.

Rapid on site evaluation means the sample is examined under the microscope while you are still in the office, to confirm enough cells were collected. If the sample is inadequate Dr. Nadelman takes another one in the same visit, which is what prevents the repeat procedures that happen when an outside lab reports an inadequate sample days later.

1125 S. Beverly Drive, Suite 602, Los Angeles, CA 90035. It is the glass tower on the west side of South Beverly Drive, and Suite 602 is on the sixth floor. There is metered parking on the street and a paid garage with the entrance on the south side of the building. Coming from the 10, exit Robertson. The office is a few minutes from Century City, Beverly Hills, Culver City and Westwood.

No. You can book directly. If a physician has already ordered the biopsy, bring the order and any recent imaging with you, and the results will be sent to whichever doctor you name as well as to you.

Same day and next day appointments are usually available, which is the reason most patients come here rather than wait out a hospital referral. If you cannot get to Los Angeles, house calls are available anywhere in California.

Coverage depends on your plan and on what is being biopsied. The carriers Dr. Nadelman accepts, including Anthem Blue Cross, Aetna, Cigna, Blue Shield of California, SAG/AFTRA and Medicare, are listed on the insurances we accept page. It is worth checking your own plan before the appointment.

A fine needle aspiration uses a thin hollow needle, typically 27 to 23 gauge, to draw out individual cells for cytological diagnosis. A core needle biopsy uses a much wider needle to remove a small cylinder of tissue, which usually means a small incision, stitches and a longer recovery. For thyroid nodules, lymph nodes and many breast lumps, an FNA answers the question without any of that.