Ultrasound-Guided Aspiration/Core Biopsy

ImageWhen a breast ultrasound reveals a suspicious breast abnormality, a physician may choose to perform an ultrasound-guided biopsy. Because ultrasound provides real-time images, it is often used to guide biopsy procedures.

What Is Cyst Aspiration?
A cyst is an abnormal sac filled with fluid. When a cyst is causing significant tenderness or the diagnosis of a cyst remains in question following an ultrasound, it may be aspirated.

For a cyst aspiration, you usually lie on your back, or slightly turned to one side, with your arm placed comfortably under your head.

The skin is cleaned and numbed with topical anesthesia. Using an ultrasound for guidance, a small needle is inserted into the cyst to draw the fluid out, causing the cyst to collapse.

The aspirated fluid may be discarded or, if bloody, sent for evaluation. Cysts may recur after aspiration.

If breast cancer is suspected following a diagnostic mammogram, ultrasound or MRI a fine-needle aspiration may be recommended.

What Is Fine-Needle Aspiration?
Fine-needle aspiration is a method of collecting cells from tissue to look for signs of cancer, infection or other conditions. A thin needle is inserted into a lump to withdraw a sample of cells or fluid. The sample is then examined under a microscope.

Your radiologist will clean the skin and, in most cases, numb the area of your breast where the needle will be inserted with local anesthetic. Holding the lump steady with one hand, the radiologist will insert a thin needle into the lump and remove the tissue or fluid. The needle may be moved in and out of the area to make sure to get enough tissue or fluid for the biopsy.

The process takes a few seconds to a few minutes. After the needle is removed, the sample is sent to pathology for review.

If the radiologist cannot easily feel the mass, your doctor may use imaging, such as a CT scan, ultrasound, MRI or mammogram, to guide the needle. If the lump is a cyst, the fluid is removed and the lump usually goes away.

How Will It Feel?
If you receive a local anesthetic, you may feel a brief sting when it is injected. You also may feel some pressure when the biopsy needle is inserted. The site of the fine-needle aspiration may be sore for a couple of days, and you may have a bruise. You should be able to return to work the same day or the next day.

What Are the Benefits and Risks?
Benefits

  • It’s less invasive than surgical biopsy, leaves little or no scarring and can be performed in less than an hour.
  • It reliably provides tissue samples that can show whether a breast lump is benign or malignant.
  • Compared with stereotactic breast biopsy, the ultrasound method is faster and avoids the need for ionizing radiation exposure.
  • The radiologist can follow the motion of the biopsy needle as it moves through the breast tissue.
  • It allows evaluation of lumps under the arm or near the chest wall, which are hard to reach with stereotactic biopsy.
  • The procedure is less expensive than stereotactic biopsy.
  • Recovery time is brief and patients can soon resume their usual activities.

Risks

  • An occasional patient has significant discomfort, which can be controlled with non-prescription pain medication.
  • Any procedure that penetrates the skin carries a risk of infection.
  • A biopsy of tissue located deep within the breast carries a slight risk that the needle will pass through the chest wall, allowing air around the lung that could collapse the lung, but this is a rare occurrence.

Who Interprets the Results and How Do I Get Them?
A pathologist examines the removed specimen, makes a final diagnosis and sends a signed report to your primary care or referring physician, who will discuss the results with you.

Gwinnett Medical Center Imaging has multiple convenient Atlanta-area locations in Lawrenceville, Hamilton Mill and Duluth. If you would like to schedule an appointment, please call 678-312-3444.