II. Epidemiology
- Breast cysts are most common in ages 35 to 50 years
III. Indications
- Palpable Breast Mass which appears cystic (esp. suspected simple Breast cyst)
IV. Technique
- Use skin marker to mark center of lesion
- Prepare Breast skin with Betadine or Hibiclens
- Drape Breast
- Immobilize lesion between index and middle finger
- Aspirate lesion 21-25 gauge needle and 5 cc syringe
- Draw back on syringe plunger while inserting
- Withdraw and redirect if no fluid aspirated
- Apply local pressure to aspiration site
- Apply Bacitracin and bandage to entry site
V. Complications
- Pneuomothorax
- Prevent by positioning lesion over a rib
-
Hematoma
- Prevent by applying local pressure after aspiration
VI. Efficacy
- Breast FNA has lower diagnostic accuracy than Breast core biopsy
VII. Precautions: Safety
- FNA does not affect MammographySpecificity
- However mammographer should be aware of aspiration
- Aspiration does not increase cancer risk
VIII. Interpretation
- No fluid (failed aspiration)
- Consider breast Ultrasound to better localize
- Refer solid lesions for Breast biopsy
- Bloody Fluid Aspirate
- Do NOT drain cyst (discontinue aspiration!)
- Send fluid for Cytology
- Complete Breast imaging and refer to Surgery for core needle biopsy
- Non-bloody fluid aspirate
- Drain cyst completely
- Discard aspirate fluid
- Reexamine after draining cyst
- Refer to surgery if mass still present
- Repeat Breast Exam in 4-6 weeks (and consider breast Ultrasound)
IX. References
- Smith in Ryan (1999) Kistner's Gynecology, p. 197
- Lucas (2003) Am Fam Physician 68:1983-9 [PubMed]
- Marchant (2002) Obstet Gynecol Clin North Am 29:1-20 [PubMed]
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Related Studies
| Concepts | Diagnostic Procedure (T060) |
| ICD10 | 30360-00 |
| SnomedCT | 387736007, 51630005, 387735006, 268409001, 142370004, 387734005, 387733004 |
| English | FNA of breast, Fine needle aspiration breast, Fine needle biopsy of breast, breast needle aspiration, aspiration breast needle, aspiration of lesion of breast, Fine needle breast biopsy, Fine needle biopsy of breast (procedure), Fine needle aspiration biopsy of breast, Aspiration of lesion of breast, FNA - Fine needle aspiration of breast, Needle aspiration of breast, Fine needle aspiration of breast, Fine needle aspiration of breast (procedure), Needle aspiration of breast (procedure), Aspiration of lesion of breast (procedure) |
| Spanish | punción y aspiración con aguja fina de mama, PAAF de mama, punción y aspiración con aguja fina de mama (procedimiento), aspiración mamaria con aguja fina, aspiración mamaria con aguja fina (procedimiento), biopsia de la mama con aguja fina, biopsia de la mama con aguja fina (procedimiento), biopsia por aspiración de la mama con aguja fina, aspiración con aguja de mama (procedimiento), aspiración con aguja de mama, aspiración de lesión mamaria (procedimiento), aspiración de lesión mamaria |
