Fine Needle Biopsy

(FNB)

by Patty Kellicker

Definition

A biopsy is a procedure to remove a tissue sample. In a fine needle biopsy (FNB), fluid and cells are removed with a thin, hollow needle.

Needle Biopsy

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Reasons for Procedure    TOP

This biopsy is used to evaluate organ or tumor tissue. The sample may show abnormal cells, disease, infection, or inflammation.

FNB may also be done to find out how certain treatments are working.

Possible Complications    TOP

Complications are rare, but no procedure is completely free of risk. The potential complications will depend on the location of the biopsy. Your doctor will review a list of possible complications, which may include:

  • Bleeding
  • Bruise where the needle was inserted
  • Pain after the procedure
  • Infection

Factors that may increase the risk of complications include:

  • Smoking
  • Medications that increase the risk of bleeding

What to Expect    TOP

Prior to Procedure

Ask your doctor if there are any instructions you should follow before the procedure. Depending on the part of the body that the biopsy is being taken from, your doctor may ask you to:

  • Arrange for a ride home.
  • Have routine blood work.

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

  • Aspirin or other anti-inflammatory drugs
  • Blood thinners

Just before the test, you may be asked to drink a contrast material. This drink will make images clearer on x-rays or CT scans.

Anesthesia

Local anesthesia is often used. It will make the area numb. A sedative may also be used to help you relax.

Description of the Procedure

Your doctor may use images of the inside of your body to help guide the needle. This may be done with an ultrasound, x-ray, or computed tomography (CT) scan.

You will be positioned for the easiest access to the area for biopsy. The area where the needle will be inserted will be cleaned. Anesthesia will be applied to numb the area. You will be asked to stay still. A thin, hollow needle will then be inserted through the skin to the site. The needle may need to be inserted more than once. The images may be checked to make sure the needle is in the right place. After the needle is in the proper position, tissue or fluid will be withdrawn. You may feel a pinch, pressure, or nothing at all. After your doctor has the sample, the needle will be removed. The site will be bandaged.

How Long Will It Take?

The length of procedure will depend on the site that is sampled:

  • Simple biopsy of a site that is close to the surface of the skin: a few minutes in most cases
  • Deeper biopsy or one that is guided by an ultrasound or CT scan: 30-90 minutes

Will It Hurt?

The amount of discomfort you feel depends on the part of the body that is being examined. The anesthesia and sedative will prevent pain. You may feel a pinch or pressure. If you feel pain, tell the doctor right away.

After the procedure, the site will be tender. Talk to your doctor about medication to help manage discomfort.

Post-procedure Care

Be sure to follow your doctor’s instructions. In general, you should take it easy and check the insertion site.

The sample will be examined by a specialist. The results are usually ready in a few days. Your doctor will talk to you about the results.

Call Your Doctor    TOP

After arriving home, contact your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Pain, redness, swelling, heat, discharge, or a red streak in the area of the needle insertion
  • Cough, shortness of breath, or chest pain
  • New symptoms develop

In case of an emergency, call for medical help right away.

RESOURCES:

American Family Physician
http://www.familydoctor.org
National Institutes of Health
http://www.nih.gov

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca
Health Canada
http://www.hc-sc.gc.ca

References:

Abeloff M, et al. Clinical Oncology . 3rd ed. Philadelphia: Elsevier, 2004.
Biopsy for Breast Cancer Diagnosis: Fine Needle Aspiration Biopsy. University of California San Francisco Medical Center website. Available at: http://www.ucsfhea.... Accessed April 29, 2013.
Cummings CW, et al. Otolayrngology: Head and Neck Surgery . 4th ed. St. Louis: Mosby, 2005.
Fine needle aspiration biopsy. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/fineNeedleAspiration.cfm . Updated October 2011. Accessed April 29, 2013.
Fine needle aspiration, fluid aspiration, and/or core biopsy. National Institute of Health Patient Education website. Available at: http://www.cc.nih.... . Updated July 2009. Accessed April 29, 2013.
Zaret BL, Jatlow PI, Katz LD. The Yale University School of Medicine Patient’s Guide to Medical Tests . New York: Houghton Mifflin Company; 1997.
6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed April 2013 by Mike Woods, MD
Last Updated: 4/29/2013