Breast Fine Needle Aspiration Clinic

What is breast fine needle aspiration?

The procedure was originally designed to determine if we could predict which women known to be at high risk (because of personal and family history, precancerous breast disease or prior breast disease) would develop breast cancer within a 5-10 year interval. By analyzing the breast ductal cells, we are better able to predict which women are at increased risk for breast cancer in the next 5 years. The breast ductal cells are obtained by drawing them out with a small needle after the skin and breast tissue are numbed with a local anesthetic similar to what is commonly used at the dentist’s office. This may sound painful, but there is really very little feeling in most womens’ breasts after the tissue is anesthetized. A mild sedative (Ativan/lorazepam) can be prescribed if needed to help patients relax before the breast aspiration. A risk assessment breast aspiration is part of the research project and is supported by grants.  There is no charge to you for this procedure except for an office visit copayment.

Some women may also be eligible for a screening MRI study in association with the aspiration.  If so, the MRI may also be offered free of charge.  The MRI (magnetic resonance imaging) is a more sensitive way to image the breast and allows for visualization of areas of the breast that are not accessible by aspiration.  

How does the random fine needle aspiration benefit me?

A study published in the Journal of the National Cancer Institute reported on the results of 400 women who underwent random fine needle aspiration.  This study found that the two most important factors in predicting short term risk of breast cancer are a woman’s GAIL Risk Assessment determining short and long-term breast cancer risk and her random fine needle aspiration cytology (cellular) results.  [Short-term breast cancer prediction by random periareolar fine-needle aspiration cytology and the Gail risk model, Journal of the National Cancer Institute, August 2, 2000, Carol J. Fabian, et al]   Based on this finding, we are better able to determine which women are at increased risk for breast cancer in the next 4 years. This is helpful in suggesting what preventive strategies may be best for an individual patient.  Based on aspirations of about 1000 women since 1990 (most of these women returned for additional aspiration), it has been found that high risk women tend to have more breast epithelial cell changes than a control group of women with an average risk for developing breast cancer.

How will I be followed after aspiration?

If the results from your aspiration suggest that you are at increased risk for breast cancer, recommendations may include a clinical breast exam by an experienced breast clinician two times per year, annual mammography or possibly a combination of mammography and breast sonography, and possible additional imaging such as breast MRI.  In addition, you may be eligible for a clinical trial and information will be provided to you by one of our team members. If your results are normal, recommendations may include annual mammography and clinical breast examinations and less frequent (every 2-3 years) fine needle aspirations. If this is your first FNA, we generally repeat the FNA either 6 months or one year later, depending on the result of the first one. This repeat sampling provides reproducibility of the results over a short period of time.

How do I get my results?

The cytology results, which tell us what the cells in your breasts look like, are interpreted by a breast cytopathologist and are defined as normal, hyperplasia or hyperplasia with atypia.  Results will take up to three months to complete.  At that time, a provider will schedule an appointment with you to review the results along with your personal and family history, and recommend appropriate follow-up for you. 

How is my eligibility determined for the fine needle aspiration study?

You will be evaluated to undergo a fine needle aspiration as a part of your prevention consultation, based on the following partial list of eligibility factors (these criteria may have exceptions and are reviewed on a patient-by-patient basis by the prevention team)

Eligibility Criteria (pdf)

 

 

 

 
3475 Erwin Road, Wallace Bldg., Durham, NC 27705 • 919-660-6610 • dietz004@mc.duke.edu
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