Fine Needle Aspiration Cytology or FNAC is an important modality in diagnosing the causes of superficial lumps or swellings that can be felt during physical examination in the Head and neck, breast, thorax, skin, lymph nodes or other parts of your body and also deep seated lesions . In this test, tissue fragments or surrounding fluid is extracted using a fine needle from the lumps or swelling in the body and the extracted sample is examined under the microscope. This test can provide rapid diagnosis to rule out cancerous lesions. It is simple, easy to perform and can be done as an outpatient procedure
FNAC test helps as a first line investigation to diagnose the reasons behind almost all abnormal swellings that are superficial and few deep seated lesions as well like thyroid gland, lymph nodes, salivary gland, kidney, liver etc.
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What is included in an FNAC Test?
In an FNAC test, a Pathologist and a certified Lab Technician (LT) would analyze the tissue sample extracted through needle aspiration to diagnose if the cells are of benign (a non-cancerous tumour) or of malignant (cancerous cells) origin. Pathologists will also analyze the patterns of the cells or tissue and will try to conclude a few causes of swelling or lump. If a conclusion about diagnosis cannot be arrived at, further tests are advised to find out the causes.
Sample required for the test
In this test, the Pathologist along with a certified Lab Technician will perform the procedure using a syringe with a fine needle and aspirate a small amount of tissue fragments or fluid around the abnormal lump or swelling.
FNAC Test Procedure
An FNAC test procedure involves the following:
The patient will have to fill in a form about basic details and a consent form before the test.
The test does not involve prolonged fasting before the procedure. But if the pathologist/ your doctor feels there is a need for fasting they may instruct you about the guidelines.
This test takes about five minutes and is not very painful, and therefore no anaesthesia is needed. As a result, the patient may feel some mild sharp pain, but the procedure is pretty quick.
The patient is made to lie down, and the affected area is sanitized to avoid any infection. If the lesion is in the abdominal area where the Pathologist or Lab Technician cannot see or palpate the swelling, they may take the help of a radiologist to perform the procedure under imaging.
The extracted sample is smeared onto a glass slide, stained and analyzed under the microscope to check for abnormalities in the cells.
After the test procedure, usually, an ice pack is provided to help relieve the pain quickly.
How to prepare for the FNAC Test?
Before the Test
During the Test
The guidelines will be provided by the Pathologist if there is a need for fasting before the procedure. If you are taking any blood thinners or anticoagulants you will be given instructions whether you need to stop these medications , for how many days before the procedure etc., If there is a need for additional tests like coagulation profile you will be advised to get these tests done.
The Pathologist will sanitize the skin over the area of the procedure and then draw the tissue sample with a fine needle; you may feel pain, but the entire procedure will be done quickly.
Things to consider after the FNAC Test is completed?
There might be some pain, soreness in the area of the procedure. After you receive the FNAC test report, consult with your doctor, who’d be able to recommend the best treatment plan for you. Do not self diagnose or treat your health condition.
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What types of diseases can an FNAC Test detect?
FNAC test helps to diagnose different benign and malignant cancers or other lesions in the thyroid gland, breast, lymph nodes, salivary glands, kidney, liver etc.
How much risk is involved?
An FNAC test is considered safe, quick and easy to perform with no or minimal complications. You may feel the following:
Pain when the needle is inserted.
Faint or lightheaded on rare occasions which is transient.
An occasional bruise where the needle is inserted.
How long does it take to get the FNAC Test results?
Your blood report will be updated on the MFine app within the next 48 hours after blood sample collection.
Is the FNAC Test a definitive test?
Yes. An FNAC test is a definitive test in many cases. In certain cases, test results are inconclusive, necessitating a repeat or additional test.
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How to read the FNAC Test report?
After the FNAC test, a Pathologist would analyze the tissue extracted and opine if the cells are benign (a non-cancerous tumour), malignant (cancerous cells) or suspicious.
What affects the FNAC Test results?
FNAC test results can depend on the size of the lesion, type of the lesion, experience of Pathologist and lab technician. Any error while extracting tissues or while processing the sample could affect the test results.
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Where to get the FNAC Test done?
Book FNAC test online from certified lab partners in your city through the MFine app and get the test done at home.
Pathologist or Lab technician will be providing the guidelines before the procedure based on the lesion that requires FNAC test. You will be guided by the Doctor if there is any need to stop medications and if required additional tests like coagulation profile will be advised. Hence inform your doctor and Pathologist about your current medications.
Is fasting required for the FNAC test?
Guidelines on fasting will be provided by the Pathologist or Lab technician prior to the day of procedure based on the location of lesion that requires FNAC.
What are the disadvantages of the FNAC test?
FNAC can assist in distinguishing between cancerous and non-cancerous cells. But it will not help to stage the cancer or to differentiate different subtypes of tissues in certain cases.
Can the FNAC report be wrong?
Like any other bio-medical test, FNAC test results also have their limitations. As a result, you may get false negatives or false positives. However the True positive results in the FNAC test are high.
How many types of FNAC are there?
There are two types of needle biopsies. They are
Fine Needle Aspiration Cytology (FNAC) and
Core Needle Biopsy (CNB)
Is biopsy and FNAC the same?
FNAC uses a small and fine needle to extract the sample and is a less invasive procedure. On the other hand, a biopsy is a more invasive procedure which is used when there is a need for larger chunks of tissues to examine the lesion.
Can TB be detected in FNAC?
Yes, TB can be detected in an FNAC procedure.
What are the advantages of an FNAC test?
It’s less invasive compared to biopsy
Little tissue damage
Little possibility of scarring, pain or infection
Can be performed in outpatient setting
Procedure with no or little complications
Shorter recovery time
Who performs the Fine Needle Aspiration test?
A Pathologist and a Lab Technician performs a Fine Needle Aspiration test. But if the lesion is in the abdominal area where the visibility is not adequate, in such cases, they may take the help of a radiologist to perform the procedure under imaging like Ultrasound.