Fine Needle Aspiration (FNA)
The radiologist performs a breast FNA under ultrasound guidance. Local anaesthetic is injected into the breast to numb the area, and then a small gauge needle is inserted into the breast lesion. If the lesion is a breast cyst, the fluid in the cyst will be aspirated. If the lesion is solid, cells will be aspirated for pathological evaluation.
Sometimes a biopsy may need to be performed on a breast lesion to determine its nature. This involves using a specialised biopsy needle to obtain a small piece of tissue from the lesion for pathological evaluation. The radiologist will use either mammographic (tomosynthesis) or ultrasound guidance to biopsy a breast lesion. Local anaesthetic is injected into the breast prior to the biopsy to numb the area, and a small nick is made in the skin. Sometimes the biopsy is vacuum assisted, which allows for larger samples. A tiny clip marker may need to be placed at the biopsy site at the end of the procedure to mark the lesion location. If a clip marker is placed, a mammogram of the breast will need to be performed after the biopsy to document the clip marker location.
A hookwire is a fine wire with a small hook on the end which is inserted into the breast by the radiologist under either mammographic (tomosynthesis) or ultrasound guidance to localise a breast lesion. Local anaesthetic is injected into the breast prior to the hookwire insertion to numb the area. A mammogram of the breast is performed after the hookwire insertion to document its location. The surgeon then uses the hookwire to remove the correct area of breast tissue.