FNAC Test to Detect the Type of Tumor

Different tumors in different parts of the body require separate diagnostic tests. When the tumor or lump is discovered, to determine whether it is a malignant tumor and contains cancerous cell, the FNAC test or the Fine Needle Aspiration Cytology is done. The FNAC test is the most prominent test that is run to perform a breast biopsy. The FNAC test is also performed to determine the pathological process for soft tissue tumors. Since the non-epithelial extra-skeletal tissue or the soft tissue tumors do not have any architectural pattern, it makes the FNAC test quite difficult.

The FNAC test is a test done to determine or detect the type of tumour or cancer a person has. In the FNAC test or the Fine Needle Aspiration Cytology, a thin, fine and hollow needle is inserted through the skin into the lump or tumor beneath the skin, to collect samples of fluid or tissue from the lump or tumor.

When the needle or syringe reaches the tumor, the doctor suctions out the sample tissue or fluid. The sample is then sent for biopsy to test the type of the fluid or tissue and determine, whether it is a malignant tumor or not. Not only for testing the type of the tumor, but it is also done to test whether a treatment procedure is working properly or not in removing the tumor.^[1]

FNAC test or the Fine Needle Aspiration Cytology is done to examine and discover the nature of the lump beneath the skin and to detect the type of tumor. If a person has been clinically diagnosed with a palpable tumor, or even the presence of an impalpable tumor is diagnosed by any other test or symptoms, the FNAC test is run to ascertain the cause and type of tumour. Usually the causes of these lumps are infection, cysts, scars and inflammation that lead to formation of tumor. The doctor needs to perform the FNAC test to determine the cells of these tumors and thereby understand, whether the tumors are benign or of any threat to the health of the individual. Testing for the threat from these tumors commonly include the malignancy test of the tissues and fluid collected from the tumors. The areas in which commonly this aspiration test, which is the FNAC test, is done are:

• Breast tumor.
• Lymph nodes in the neck area.
• Thyroid gland.
• Swellings of soft tissue.

Any other tumor situated just beneath the skin that is accessible by the fine needle used in the FNAC test.^[2]

FNAC test in Palpable Tumors: The procedure usually begins with clinical diagnosing of the tumor if it is palpable. The medical practitioner or the doctor would then ask a few questions to know about the medical history of the lump. The patient is also explained about the process and given opportunity to ask any question relating to the FNAC test.

The areas through which the fine needle in FNAC test would be inserted, is cleaned. In some cases, a local anaesthesia is given to the individual to numb the area. However, in cases where the lump is very close to the skin, anaesthesia is not required. Then the doctor with his one hand will hold the tumor or lump steady and insert the fine needle with the other hand. The needle might be inserted in and out a few times into the tumor region, to make sure that enough fluid or tissue is collected.

As enough fluid and tissue are collected, the doctor will pull the syringe back. As the needle is pulled out, the tissue and fluid is carefully removed for sending to biopsy to detect the type of tumor. In most cases of FNAC test, a little amount of bleeding occurs after the syringe is removed and in that case, the doctor will put some pressure to stop the bleeding.^[3]

FNAC test in Impalpable Tumors: For palpable tumors, determining the position of the tumor or lump is easier. But for impalpable tumors, the FNAC test is done only after determining the position of the tumor with the help of imaging tests.

Stereotactic mammography is used to help the tumor to be pinpointed, in case of a breast mass. The mammograms, which are forms of X-rays, determine the exact location of the tumor, as the images are taken from two different locations. With the help of the computer that takes the images, the doctor guides the needle in FNAC test.^[4]

Ultrasound scan and CT scan are also other processes that help the doctor to do the FNAC test or collect the fluid and tissue from the breast mass. In most cases, these tests are done by a radiologist. The rest of the procedure of FNAC test is similar to that of the palpable tumors.

The FNAC test is the easiest procedure to determine the type of the tumour and FNAC test also helps the doctor to know whether the cancer treatment is properly and effectively working or not. As FNAC test does not require any stitches or other major surgical procedures, the patients can almost immediately resume to normal life activities post FNAC test. In case of solid tumors, the FNAC test fails to collect the tissue. In such a case, it must be supported with cytological diagnosis that is done to collect the solid tissue.^[5]

The FNAC test is an absolutely easy and simple test in comparison to other biopsy tests run in those parts of the body, where the tumors are absolutely impalpable and lying far beneath the skin. Since the tumor lies close to the skin, there is very minimum preparation that is needed. In some cases, when doing the FNAC test, if the tumor is painful or the skin is too sensitive to withstand syringe injection, a mild and local anaesthesia is given to the skin and surrounding area of the tumor. As the syringe is inserted and pulled out, a normal bleeding occurs just like any other syringe injection. In that case, the doctor puts pressure to stop the bleeding. However, those, who are taking blood-thinning drugs or anticoagulants, they are asked to stop taking those drugs before undergoing the FNAC test.

The FNAC test or Fine Needle Aspiration Cytology is a diagnostic procedure that is done mostly and usually, without any complications at all. Generally, after the FNAC test is done, the individual may experience a light soreness around the area of insertion of the fine needle. There can be a little bruise at the area where the needle is inserted. The other common complications from FNAC test include:

• Infection
• Bleeding
• Pain^[6]

FNAC test is a diagnostic test and like most other diagnostic tests, there is no guarantee that the results will be 100% accurate. However, in most cases, the benign tumors are best diagnosed with FNAC test. Although for malignancy, further tests are required to check the biopsy results. For benign tumors, the treatment procedure is different and for malignant ones, the treatment includes thorough and extensive programs.

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