A fine needle aspiration (aka ‘FNA’ or biopsy) is a procedure used to obtain cells of a suspicious growth in order to make a diagnosis of what the growth is (most commonly to rule out cancer).
The procedure is performed by using an ultrasound to visually guide a needle through the skin, directly into the growth.
The skin is typically numbed prior, requiring a pinch from a needle and stinging / burning sensation as the numbing medicine is injected.
Once the needle is in the growth, an in-and-out motion is used to core out samples of cells from the growth into the hollow of the needle.
The needle is typically in the neck for about 5 seconds or less before it is removed.
The contents of the needle are then squirted on to a slide and prepared for a pathologist to look at under a microscope.
If the pathologist does not receive enough cells to look at, they will not be able to make a diagnosis and the procedure would need to be repeated.
To lower the risk of a non-diagnostic result, typically 4 passes are made with different needles.
The entire process takes about 10-15 minutes.
If cancer is present in the growth, there is no risk for spreading cancer cells elsewhere in the body when performing the FNA.
The results of an FNA are accurate and reliable ~ 98% of the time.
Contrary to previous beliefs, thyroid nodules larger than > 4.0 cm do not have increased risk for a false negative biopsy (missing cancer).
The FNA can be performed on the same day of the consultation in the office, with the entire visit lasting ~ 40 min.
Yes, it is safe for you to drive home from after the procedure.
You can take an anti-anxiety medication at the appropriate amount of time before the procedure.
Please have someone bring you to the office visit and drive you home after taking the anti-anxiety medication.
Once the FNA is completed, the neck is cleaned and a small band-aid is placed, which can be removed the next morning.
The numbing medication wears off in 1-2 hours.
There can be some mild discomfort for 1-2 days following.
There are no activity restrictions following the FNA – you can drive, eat, drink, exercise, sleep and relax in any neck position, etc.
Ice compresses, Tylenol, and/or an NSAID’s such as Ibuprofen / Motrin / Advil / Aleve are helpful to control discomfort.
Results are typically finalized in 1-2 business days, and you will receive either a MyChart message or phone call notifying you of the results.
Insufficient cells (aka non-diagnostic result) requiring repeat FNA; ~ 5% risk.
Bleeding from the growth resulting in significant swelling and bruising (aka hematoma) is very rare; < 1%.
Infection as a result of the FNA is very rare, < 1%.
The consultation and FNA can be performed on the same day, with the entire appointment taking ~ 40 min.