Breast lumps other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Other Diagnostic Studies

Fine Needle Aspiration/Biopsy

Fine Needle Aspiration

• Office procedure for evaluation of palpable cyst (22-24 gauge needle)
• Bloody fluid

• Send for cytology and refer for surgical biopsy

• Non-bloody fluid

• Cytology extremely low yield (do not send)
• If mass disappears, reexamine pt in 4-6 weeks
• If no recurrence, resume routine follow-up
• If recurrence, can repeat aspiration
• Consider biopsy if further recurrence

• Non-bloody fluid but residual mass after aspiration: surgical biopsy
• Solid mass (no fluid)

• Surgical biopsy or fine needle aspiration biopsy

Fine Needle Aspiration Biopsy (FNAB)

• Aspiration of cells from a solid mass
• 21 gauge needle, operator-dependent
• Wide variation in sens (65-98%), spec (34-100%)

Core Needle Biopsy

• 14-18 gauge needle allows for better histologic sample
• Used mostly for evaluation of non-palpable masses (mammogram or ultrasound guidance)
• Compares favorably with surgical biopsy at lower cost

Excisional Biopsy

• Recommended if solid mass suspicious for cancer by exam or mammo
• Also recommended for palpable mass not seen on mammogram or for abnormal biopsy

References

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