Superficial biopsy or Fine Needle Aspiration under Ultrasound guidance

What is an ultrasound guided biopsy?

A biopsy is a minimally invasive procedure used to obtain a tissue sample from a lump or abnormal area. Ultrasound uses sound waves to produce real-time images of anatomical structures. These images guide a small needle to the area of concern to collect a small tissue sample, which is then sent to a laboratory for analysis.

Why do I need a Biopsy?

Your doctor has referred you for a biopsy because you have a lump or abnormal area that requires further investigation. Analysis of the biopsy sample helps determine the nature of the lump and guides further management.

Are there different types of biopsies?

Yes. The type of biopsy will be decided by the doctor overseeing your care. The two main types are:

• Fine Needle Aspiration (FNA): Uses a very fine needle to collect a sample of cells. In some cases, the sample may not contain enough cells for accurate analysis, and the procedure may need to be repeated. Local anaesthetic is used for some procedures but not all.
• Core Biopsy: Uses a slightly thicker needle to collect a larger tissue sample. Again, in some cases, the sample may be insufficient, and a repeat procedure may be required. Local anaesthetic is used for some procedures but not all.

How do I prepare?

You may eat and drink as normal on the day of the biopsy. It may be helpful to bring a friend or relative, although they will usually be asked to wait outside the ultrasound room during the procedure. Please bring a list of all your medications.

You may have been advised to stop any blood thinning medication such as:

• Warfarin
• Clopidogrel
• Apixaban
• Rivaroxaban
• Dabigatran
• Dipyridamole

The length of time these medications need to be stopped varies, so please ask your doctor if the advice is unclear.

How is it performed?

Upon arrival, check in at the reception desk. You will then speak with the practitioner performing the biopsy, who will explain the procedure and possible side effects. You will be asked to give your consent and may be asked to sign a consent form.

The procedure will be performed by either a radiology doctor or a sonographer trained in biopsies.

You will be taken to the procedure room and offered the option to change into a hospital gown. You’ll lie in a comfortable position on the ultrasound couch. The practitioner may examine the area of concern with ultrasound to plan the procedure.

Your skin will be cleaned with antiseptic solution and a sterile drape will be placed over the area. Local anaesthetic will be used to numb the area this may feel like a sharp scratch followed by some stinging. A needle will then be inserted into the lump to collect tissue samples. Up to four samples may be taken to ensure enough tissue is collected for diagnosis. Your procedure including set up typically takes around 20 minutes, however obtaining the samples is typically much shorter.

Who will I meet?

Interventional Radiology (IR) procedures are performed by a multidisciplinary team. The team includes the following key staff:

Interventional Radiologist (Consultant/Fellow):

A doctor specially trained in minimally invasive, image-guided techniques who performs the procedure.

Sonographer:

A health care professional specially trained in some minimally invasive procedures

Radiology Nurses:

Highly trained nurses who care for the patient.

Senior Clinical Support Workers (SCSWs):

Assist with the setup of the room, patient positioning, and maintenance of sterile conditions.

What are the risks?

There is small risk of bleeding/bruising or infection. More severe bleeding is extremely uncommon.

Occasionally, the sample may be insufficient for diagnosis, and the test may need to be repeated.

What happens after the biopsy?

Due to the small risk of bleeding, you may be asked to wait in the department for 15 minutes to ensure there are no immediate issues before going home.

You may experience mild discomfort at the procedure site for 1-2 days. If needed, painkillers such as paracetamol can help. Avoid taking medication that contains ibuprofen or aspirin for the first 24 hours after the biopsy, as these can cause extra bruising.

Aftercare Queries:

Please seek immediate medical attention if you experience severe symptoms such as uncontrollable pain and breathing difficulties.

For routine or non urgent queries: