Ultrasound Guided Fine Needle Aspiration Biopsy (FNA)

Patient Information Leaflet

Introduction

This information leaflet has been provided as you have been referred for a possible or planned ultrasound guided fine needle aspiration which is a type of biopsy (sometimes referred to as ‘FNA’). This is usually to investigate the cause of a lump or swelling found either by physical examination or on another scan.

If you have not already had imaging of the area then an ultrasound examination will happen first and then a decision whether to continue on to do the FNA will be made with you.

What is a Fine Needle Aspiration Biopsy (FNA)?

This is a test using a fine needle (usually smaller than a blood-test needle) that is inserted through the skin in order to take a small sample of cells from the area being tested. The sample is then sent to the laboratory for examination under a microscope by specialist pathologists.

What are the benefits of the procedure?

The purpose of the procedure is to find out what type of tissue is causing the lump or swelling, for example if it is cancerous or benign (not cancerous). This will allow discussion as to whether further treatment or monitoring is required.

Who performs the procedure?

The procedure will usually be performed by a radiologist (a doctor who specialises in imaging) or a specialist sonographer. The procedure will take place in an ultrasound room.

Preparing for a biopsy:

Please inform us in advance if you:

• Have mobility issues or require assistance.
• Have a current infection.
• Have a latex allergy.
• Are taking any anticoagulation (blood thinning treatments) and have questions not answered below:
• Apixaban/Rivaroxaban/Edoxaban should be stopped 1 DAY BEFORE your appointment.
• Warfarin should be stopped 2-3 DAYS BEFORE to your appointment.
• Aspirin and Clopidogrel DO NOT need to be stopped.
• For any other anticoagulants please call to let us know what you are taking, who prescribes this for you and what it is for, we will look at each case individually.

About the procedure

The procedure will be explained to you again on the day and you will be able to ask any questions that you may have. Including discussions, the procedure lasts around 30 minutes. You may wish to bring a companion with you, especially if you are nervous.

The radiologist/sonographer will determine the site for biopsy using the ultrasound machine with you lying or sitting on a couch. The area will be draped and the skin cleaned with a sterile solution. The biopsy usually involves 2-4 needle punctures. These usually take just a few seconds each and usually the needle used is thinner than a blood test needle. Local anaesthetic is not usually used it requires additional needle puncture. In our experience the procedure is tolerated much like an injection or drip.

Unfortunately, if you are late for your appointment, we may not be able to offer the procedure on the same day. Please note the appointment time, allow time for parking and checking in at our front desk.

After the procedure

You may eat and drink normally. Avoid strenuous activity for 24 hours. There are no restrictions to driving afterwards providing that you feel well.

Results take around two weeks and go directly to the Doctor who ordered your test.

What are the risks?

When performed by specialists, FNA is a safe procedure with minimal risks.

As with any needle test, there is a small risk of bleeding and bruising which will usually settle without any treatment. Minor soreness will usually settle quickly with simple treatments such as painkillers and cool packs. There is also a small risk of damage to nearby structures, such as glands, muscles, nerves and blood vessels.

Deeper bleeding and bruising is very uncommon but if there is visible swelling, significant discomfort or any effect on your breathing you should return to the department. Out of regular hours (9-5 Monday to Friday) this would need to be the Emergency Department. If symptoms are severe, you should phone 999.

There is an extremely small risk of infection. If you experience swelling, redness or increasing pain or temperature, you should contact your referring doctor via their secretary or your GP. If you have a specialist nurse, they may be able to help.

Finally, even if the procedure goes as planned, there is an approximately 1 in 10 chance that the sample taken does not give an answer. In such cases your doctor will consider whether to repeat the test or discuss alternative options.

Are there any alternatives?

You do not have to have any procedure that you do not want. Please discuss with your doctor what alternatives may be available, such as monitoring with scans, different type of biopsy or surgical options.

Contact details

You can contact the Russells Hall Hospital Ultrasound Department on 01384 456111 ext. 2002 / 2030.

If you need urgent medical help or advice, but it is not a life-threatening situation or 999 emergency, please call NHS 111.

If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on 01384 456111 and ask for the relevant department who issued this leaflet.

Please keep this leaflet in case you need to refer to it after the procedure.

If you have any feedback on this patient information leaflet please email dgft.patient.information@nhs.net

This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.

Originator: Ayeshea Shenton . Date originated: 14.11.2025  . Review date: 14.11.2028  . Version: . DGH ref.: