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Types of Biopsy's?

Fae's picture
Fae
Posts: 22
Joined: Jan 2013

Can someone tell me a little about Biopsy's. Is the FNA as accurate as a full removal? If you are very nervous and have quite a few symptoms, what is the best route to go? 

allmost60's picture
allmost60
Posts: 3176
Joined: Jul 2010

Hi Faye,

 My PCP and Onc doctors both told me that removal and pathology of a node is the best way to determine if cancer is present and also determine stage and grade. Mine is FNHL-stage3-grade2-typeA. So far no bone involvement. I have read the FNA sometimes does not have enough in the fluid specimen to determine everything necessary for a complete and accurate diagnosis. Ask your doctor on your next visit what he thinks is best. Best wishes...Sue

Fae's picture
Fae
Posts: 22
Joined: Jan 2013

Hi Sue, Thanks for the info. I'm gonna be pushing for all the tests. I won't take a "lets wait and see". I need to know now if I have something and if so what I have. So I want to be informed when I do talk to my doc and I want to know what I would like done as far as testing. Thank you so much. 

 

onlytoday's picture
onlytoday
Posts: 596
Joined: Jun 2010

Fae,

 

I responded to your post an hour ago and it disappeared!  Hmm.

Anyway... what I said was that I agree with what Sue said.  I first had a needle and core biopsy only to end up needing a full removal of the lymph node for a correct diagnosis.

 

Good luck - I'm sure your doctors will do what is right.  Please keep us posted.

 

Donna

GKH
Posts: 327
Joined: Jul 2012

Hi Fae

Needle biopsies are definitely not as accurate as node removal for diagnosing whether or not you have a problem. From the description you gave, your nodes are near the surface and easily accessible. It should be very quick and relatively painless. By that I mean it won't hurt when you do it but may be a little sore afterwards.

 

Garry

po18guy
Posts: 245
Joined: Nov 2011

Needle biopsies are cheap and quick, which is why they are a first resort. However, they are notoriously inaccruate and can provide false negatives. They remove far too little tissue to reliably make a first diagnosis, especially since the pathologist does not know what type pf cell they are looking for. If you have a prior diagnosis of cancer, and suspect a relapse, then the pathologist knows the exact type of malignancy to look for. A node excision provides many times more tissue to examine. As well, the pattern for cancer in a lymph node is that the clonal process will completely efface nodal architecture. What the heck does that mean? Well, think of your lymph nodes as being like tiny oranges. once you peel the skin away, they have segments that are visible. When cancer cells accumulate in a lymph node, they replace the existing node structure with a mass of cancer cells clumped together. There are no more visible segments, meaning that abnormal cells - most likely malignant - have taken over. An excisional biopsy will allow the pathologst to look for this change in the node in addition to microscopic examination of the individual cells in the node. A node that is near the surface of the skin is not that much more complicated than having a mole removed from your skin. Walk in, walk out.

Fae's picture
Fae
Posts: 22
Joined: Jan 2013

Is it possile that the node they biopsy is not malignant, but onother one could be? As I had mentioned in another post, I have ones that I have had for years, and also some new ones. The old one would be the easiest to remove. 

GKH
Posts: 327
Joined: Jul 2012

Fae I think you are in an excellent position for a quick, easy and painless biopsy. I spoke to onc about it. He said FNA is ok for a yes/no answer in most cases. However he always asks for the node to be removed if its in an easily accessible location because they use the material to type the cells for dna changes and a lot of other tests. My nodes were deep in my chest. The surgeon attemped FNA but that was not possible so I had major surgery. I think you are fortunate in that biopsy should not be a big ordeal like mine (7 nights in hospital). Just think how relieved you will be to know you are OK.

 

my best

Garry

miss maggie
Posts: 929
Joined: Mar 2010

Hello Faye, I have no idea what FNA is.  My small bowel perforated in Sept 2009, and was resected. They removed what was perforated. From the biopsy, the doctor was able to dx me, NHL.

 

Maggie 

allmost60's picture
allmost60
Posts: 3176
Joined: Jul 2010

Hi Maggie,

 Here is an explanation what FNA means:

Fine Needle Aspiration (FNA)

This is a fairly easy and well tolerated procedure. It is most commonly done as outpatient. Normally there is no need for sedation. A very thin and fine needle is inserted into the tumor site and cells are extracted for laboratory studies. If a tumor is visible or easily palpable, FNA could be done in a matter of minutes. For tumors that are located in deep areas, the procedure is normally done under indirect visualization of the tumor site with CT Scan or Ultrasound.

cathyp's picture
cathyp
Posts: 366
Joined: Dec 2009

I had a FNA 3 weeks ago for a lymph node at my masectomy site along the chest wall.  It would have been extremly easy to remove the enitire node but a FNA was done.  Frankly, I didn't question why the FNA vs the removal.  It may be because it is unknown how I would heal from any incisions done on my radiated skin, for one. After locating the node by Ultrasound, they inserted the needle 3 times to get enough sampling for a good biopsy.  My results were benign!  It was an extremely easy well tolerated procedure.  I was told to just keep an eye on it for any changes. 

Fae's picture
Fae
Posts: 22
Joined: Jan 2013

Would a CT scan always be ordered before an FNA or Biopsy? Or if they could see the lump clearly, would they FNA without checking for other swollen nodes? Sorry for all the questions, I just want to be informed when I see the doctor and know what to expect. Also, I didn't quite understand about whether or not one particular swollen node can be benine, but possiblly have maglignant ones else where? Is this possible or would it show up in any swollen lymph node? Thx again.

GKH
Posts: 327
Joined: Jul 2012

My nodes were discovered during a ct scan for back aches. I would think you should be able to choose whether or not to get a scan first. Direct things. Be the hammer not the nail! Dr advice is just that - advice. The decision is yours.

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