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Fine Needle Aspiration (FNA)

This consist of attaching a syringe with vacuum to a 23G needle and making multiple passes through a palpable abnormality. The aspirate is placed on a slide. The cytotechnologist or pathologist is present to assess for adequacy of sample. If the sample is inadequate, additional passes are made. Occasionally a mammographer will aspirate a complex cyst for diagnosis. If serosanguinous (bloody) fluid is aspirated it should be sent to the lab for cytological evaluation.

Advantages:
1. Considered non-invasive.
2. Quick and inexpensive procedure.

Disadvantages:
1. Many pathologist are uncomfortable with making diagnosis based on cytology (cells) without tissue
2. May be inaccurate with some lesions such as Invasive Lobular Carcinoma, which yields few cells.
3. Generally limited to a palpable abnormality.
3. May be non-diagnostic requiring excisional biopsy.