What is a fine needle biopsy?
Fine needle aspiration biopsy (BAC) is a technique for collecting material for histopathological examination. A biopsy is performed when various types of cancer are suspected, e.g. thyroid, salivary gland, breast, nipple or prostate cancer. Biopsy is a non-invasive method that does not require anesthesia. The basis for the biopsy is the detection of the nodule by palpation, ultrasound examination (USG), radiological examination (X-ray) or computed tomography (CT) or scintigraphy. In the case of small nodules, there are cases where the needle does not hit a pathological lesion (the lesion is 2 - 3 mm in size), but it happens relatively rarely. However, it is worth remembering that a negative test result is not synonymous with the absence of neoplastic changes. If the biopsy result is inconclusive, the test should be repeated in about 3 months. In the case of, for example, breast cancer, the biopsy is 80-96% effective.
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What is a fine needle biopsy?
BAC is a method of collecting pathological tissue material for cancer diagnosis. During the examination, the tumor cell suspension is aspirated together with the intercellular fluid by insertion with a fine needle and aspiration into a sterile syringe. Only a cell aspirate is taken from the patient, not a tissue section.
The test is usually performed in a lying or sitting position, depending on the location of the lesion. Although the examination usually does not require local anesthesia, sometimes the doctor decides to administer local anesthesia in the form of a 1% lidocaine solution. Needles with a diameter of 0.6 - 0.8 mm are most often used, and syringes with a capacity of 5 - 20 cm3. After piercing the skin and pricking a tumor, e.g. of the salivary gland, thyroid gland, breast, nipple, the needle is moved up and down several times, each time changing the direction of the needle. Thanks to this action, the probability of taking the right amount of cells of the diseased tissue increases. The material is then pumped out of the syringe onto a microscope slide and fixed. The entire process takes approximately 15 minutes. The result, however, is available after 24 hours.
The collected cells are then subjected to a cytological examination, during which they are specially stained and examined under a microscope. The pathologist assesses the appearance of the cells and their staining with various dyes that respond to the type of cells in the aspirate. Most often, the biopsy is performed under ultrasound guidance (fine-needle aspiration biopsy). Ultrasound control makes it possible to precisely collect material for examination, even for small lesions. A biopsy is simple, inexpensive, and quick.
Preparing the patient for a biopsy
Before collecting the material from the lesion by fine needle biopsy, no special preparation of the patient is required. It is advisable to dress comfortably due to possible tenderness in the biopsy area. If the patient has, the results of ultrasound, X-ray, CT or magnetic resonance imaging should be taken. It is recommended that you bring your blood test results with you if you have a thyroid biopsy. Documents from the operation and other histopathological examinations should also be taken.
Complications after fine needle biopsy
Usually, there are no complications after a BAC biopsy. Sometimes a small hematoma is left at the site of aspirate collection. A bruise cream can be used to accelerate the resorption of the hematoma.
Could a biopsy make the lesion / nodule malignant?
From the oncological point of view, a nodule biopsy puncture is completely safe and does not turn the nodule into a malignant one or does not accelerate its growth.
Other uses for fine needle biopsy
BAC biopsy can also be used to decompress large cystic changes in the breast or thyroid gland. A decompression biopsy helps to reduce pain. Moreover, a biopsy is also used to diagnose lymph nodes in the case of suspected metastasis of malignant neoplasms. BAC biopsy can also be used to diagnose changes in the abdominal cavity, e.g. in the liver, pancreas. However, this is a more demanding procedure, after which the patient usually stays in the hospital for one day. Core-needle biopsy is used to diagnose malignant neoplasms.
Is a fine needle biopsy always 100% effective?
As mentioned above, the unfavorable localization of the lesion or too little aspirate with the biological material suitable for testing may affect the effectiveness of the biopsy. In 20-26% of cases, the biopsy result is inconclusive. However, this is not the result of the pathologist's lack of skill. It happens that the collected amount of material is not sufficient for a pathologist to make a clear diagnosis. In such situations, the procedure is repeated after 3 months. If cancer is excluded, an urgent oncological consultation is also necessary.
Steps:
- ultrasound examination
- performing a biopsy
- preparation of the test result in an urgent mode 24 hours after collecting the material
- consultation of the result with the diagnosing physician
