Recommendation

If you have a breast lesion that may be a sign of cancer, what procedure should you be offered to diagnose the lesion: needle core biopsy or fine needle aspiration cytology?

Needle core biopsy, as recommended by the ECIBC's Guidelines Development Group (GDG), rather than fine needle aspiration cytology.

Who is this recommendation for?

You had a mammogram or other screening test that showed a lesion.

You may have been told that the lesion may be a sign of cancer and you wish to have the lesion tested. So, a sample of tissue from your breast is needed to test for cancer.

The lesion could be one of the following:

  • a mass in your breast
  • calcium deposits in your breast
    called calcifications or microcalcifications
  • an area of dense tissue only in one of your breasts
    (also called asymmetric)
  • an abnormal structure of your breast tissue

What would following this recommendation mean for you?

It might be important to speak with your healthcare professional about the abnormal results of your mammogram or other screening test.

You may wish to speak with your healthcare professional about how the needle core biopsy is performed and how you feel about:

  • your comfort during and after the procedure
  • the chances of an incorrect diagnosis or finding cancer
  • what happens after you have the results
  • any concerns you have about whether a biopsy could cause cancer to grow faster or spread,

Definitions

Biopsy: is a procedure that obtains a small amount of breast sample from a suspicious area to be tested for cancer.

Fine needle aspiration cytology (FNAC) uses a thin needle to aspirate the sample.

Needle core biopsy (NCB) uses a larger needle attached to an automated device or a suction device (vacuum-assisted needle core biopsy) to obtain breast tissue.

Additional considerations

With needle core biopsy more women are correctly diagnosed and fewer are told they have breast cancer when in reality they do not.

With needle core biopsy it is also possible to identify the type of tumour and then study how the tumour is likely to behave.

Although the needle used for a needle core biopsy is larger than the one used with fine needle aspiration cytology, the chances of bleeding or pain are only slightly higher.

The GDG noted that the cost of providing needle core biopsy may be slightly greater than providing fine needle aspiration cytology. However, since there are more correct diagnoses with needle core biopsy, the test may not need to be repeated, and money would be saved.

Documentation for professionals