Women who face the possibility of a breast cancer diagnosis are often faced with choices between a fine needle aspiration (FNA) or an open biopsy of the breast. Both of these techniques are used to obtain specimens in order to determine if cancer is present and if so, what the stage of the cancer is. Staging is important in deciding treatment, so the earlier and more accurate the staging diagnosis, the sooner treatment can be initiated.

What is an FNA?

An FNA is actually well-described by its name. A very fine hollow needle is inserted into the potential tumor by a doctor who is a fine needle aspiration specialist. Tumor cells and fluid are aspirated (sucked up) through the needle and immediately placed on slides for microscopic examination. The cytopathologist can quickly determine whether the cells are cancerous and how far the cancer has progressed. The stage of the cancer indicates where it is located, how fast it is developing and if (or how far) it has spread.

What is an Open Biopsy?

An open biopsy is another way to obtain a specimen of a possible tumor. The surgeon makes an incision (cut) in the breast and removes some or all of the lump for examination. The incision is closed with staples or sutures. The lump is sent to the pathology laboratory for microscopic examination. The pathologist views slides onto which the lump has been sectioned (very thinly sliced) and makes the diagnosis. Staging is also performed at that time by the pathologist.

FNA vs Open Biopsy

Although both an FNA and an open biopsy achieve the same results, an FNA has some distinct advantages. A fine needle aspiration specialist can perform the FNA in the office; it takes only a few minutes, and neither anesthesia nor stitches are necessary. The results may be available within a day. An open biopsy requires local anesthetic. In most cases, the biopsy is performed by a different doctor than the doctor who makes the diagnosis and the diagnosis takes longer. An FNA is also typically less expensive.