Open Biopsy After a Negative Fine Needle Aspiration

Kevin R. Fox, MD
Last Modified: October 27, 2002

Question:

Dear OncoLink "Ask The Experts,"
Please comment on when you should have an open biopsy after a negative fine needle aspiration (FNA). In 2001 I had a FNA, which was negative, and several months later the lump turned out to be breast cancer after an exisional biopsy. Now a year after treatment for a low-grade tumor (lumpectomy/radiation therapy), I have a hard lump near the lumpectomy scar. I just had a FNA. If it comes back benign, is it reasonable to follow the lump? At this point, I'm not confident on the reliability of FNA's. Thanks for your comments.

Answer:

Kevin R. Fox, MD, Assistant Director, Clinical Affairs and Associate Professor of Hematology/Oncology at the Abramson Cancer Center of the University of Pennsylvania, responds:

A Fine Needle Aspiration (FNA), when negative, should almost always be followed by an excisional biopsy. The only exception is when a FNA is done for a simple cyst. In all other circumstances, including the current one, the standard of care would favor an excisional biopsy.

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