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Open Biopsy After a Negative Fine Needle Aspiration

Open Biopsy After a Negative Fine Needle Aspiration

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.