Fine-Needle Breast–Aspiration (General Surgery)

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SAMPLE EXCERPT
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PRE-PROCEDURE
INDICATIONS
  • Presence of a palpable suspicious mass in the breast
CONTRAINDICATIONS
  • Unskilled clinician (relative)
  • Absence of a cytopathologist capable of properly interpreting the resulting slides
  • Sites of active pyogenic infection
  • Nonpalpable lesion (unless visualized on office ultrasound)
  • Bleeding studies are in the therapeutic range for anticoagulated patients
  • Severe immunocompromise
EQUIPMENT
  • Aspiration syringe
    • The syringe pistol
    • Tao Aspirator
    • Milex breast aspiration biopsy needle
    • A 21- or 23-gauge butterfly connected to a syringe (requires an assistant)
    • A 21- or 23-gauge needle on the end of a regular 3-, 5-, or 10-mL syringe
  • Two sterile, plain (nonanticoagulant), evacuated blood tubes
  • 21-, 22-, or 23-gauge needle
  • Syringe of appropriate size
  • Specimen containers with CytoLyt solution
  • 4 × 4 gauze pads
  • Sterile gloves
  • Isopropyl alcohol pads or povidone-iodine swabs
  • 1-mL syringe with 30-gauge half-inch needle and 1% plain lidocaine (optional)
ANATOMY
  • The mammary glands drain into lactiferous ducts. Several ducts coalesce into an ampulla that then drains directly onto the surface of the nipple.
  • Fibrous and cystic changes can occur in the mammary glands.

PROCEDURE
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The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

POST-PROCEDURE
CARE
  • Compress the site with a gauze pad for 5 to 15 minutes to minimize bruising.
  • Place folded gauze pads under a snug brassiere for a compression dressing.
COMPLICATIONS
  • Diagnostic failure or false-negative and false-positive results
  • Minor hematoma formation
  • Pneumothorax (rare)
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