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Fine-needle aspiration is a minimally invasive way to obtain a cell sample to confirm a diagnosis or guide treatment. Fine-needle aspiration is an alternative to more invasive methods such as incisional or excisional biopsy. This activity reviews the procedure of fine-needle aspiration and reviews the role it plays in evaluating suspicious masses, as well as highlighting the role of the interprofessional team in this procedure. Objectives: Identify the indications for fine-needle aspiration. Describe the technique in regards to effectively performing fine-needle aspiration. Review the appropriate evaluation of the potential complications of performing fine-needle aspiration. Summarize interprofessional team strategies for improving care coordination and communication to properly perform fine-needle aspiration and improve outcomes. Access free multiple choice questions on this topic.

Whether found on personal examination, by a physician on clinical examination, or incidentally found on imaging, new growth or mass can be extremely alarming to a patient. Ensuring a quick and accurate diagnosis with minimal psychological and physical suffering on the part of the patient should be the healthcare team's highest priority.[1] While an effective and thorough history and physical combined with advanced imaging modalities can now diagnose with a high degree of confidence, the etiology of many new masses, sometimes there is still diagnostic uncertainty. In these cases, a tissue or fluid sample is typically necessary to confirm the diagnosis. Furthermore, in the era of advanced biologic drugs and genotyping, a tissue sample combined with genetic and molecular testing may be necessary to determine the most effective treatment modality even when a diagnosis is known. Finally, in limited cases, fine-needle aspiration may be used therapeutically to remove fluid from abscesses, cysts, or seromas.

Fortunately, complications associated with fine-needle aspiration are relatively rare. Bleeding, damage to surrounding structures, and fistula creation are all minimized by the small size of the needle. The greatest risk is for bleeding in patients that are coagulopathic for any reason. In these patients, manual compression is typically enough to stop the bleeding. The other major potential complication is to seed tissue planes with infection or neoplastic cells while passing the needle through them to reach the area to be aspirated. This is why it is essential to consider whether a fine-needle aspiration is necessary to guide treatment or whether definitive treatment should be pursued in the absence of fine-needle aspiration.

The most critical step for any fine-needle aspiration is the decision of whether or not it will actually change the management of the patient for whom it is being planned. Everyone on the entire interprofessional healthcare team (clinicians, mid-level practitioners, nurses) should be in agreement that a cytology sample is necessary to determine the appropriate treatment for the patient and that fine-needle aspiration will be sufficient to attain this rather than a more invasive method such as core-needle biopsy or excisional biopsy. When the procedure is being performed, the entire healthcare time should take every precaution necessary to ensure that sterile technique is maintained to minimize the risk of spreading infection.