Ultrasound-Guided Biopsy & FNAC in Dadar West, Mumbai

At a Glance

FNAC or biopsy: what is the difference?

Both use a needle to take a sample from a lump for examination under a microscope. Live ultrasound shows the lump and the needle tip throughout, which helps make sure the sample comes from the right place and that blood vessels are avoided.

Biopsy is बायोप्सी in Hindi and Marathi; a lump is गांठ in Hindi and गाठ in Marathi.

• FNAC (fine needle aspiration cytology): a very thin needle, similar to a blood-test needle, draws out cells. It is the usual first test for a thyroid nodule and is often used for lymph nodes.
• Core biopsy: a thicker hollow needle takes a few thin strips of tissue, on which the laboratory can run extra tests. It is usually preferred for a suspicious breast lump, when lymphoma (a cancer of the lymph glands) is suspected, or when an FNAC has not given a clear answer.

When doctors request an FNAC or biopsy

A scan shows where a lump is and how it looks; often only a sample can say what it is. Common reasons for a referral:

• Thyroid nodule: most are harmless and not every nodule needs FNAC; the decision depends on its size and ultrasound appearance, often scored as TI-RADS.
• Lymph node in the neck, armpit or groin that stays enlarged for more than a few weeks or looks unusual; FNAC can often show infection, including tuberculosis (TB), or abnormal cells, and your doctor will advise if any further tests are needed.
• Breast lump reported as suspicious (BI-RADS 4 or 5), or an abnormal node in the armpit.
• Other lumps under the skin or in the soft tissues, when your doctor needs to know what they are before treatment.
• Fluid: a cyst, a fluid collection or fluid around the lung (pleural fluid) can be drained under ultrasound guidance and, if needed, sent for tests.

How to prepare

Our team confirms the exact preparation when you book on WhatsApp. Tell us then if you take a blood thinner (such as aspirin, clopidogrel, ticagrelor, warfarin, acenocoumarol/Acitrom, apixaban, rivaroxaban or dabigatran), have a bleeding problem or liver disease, are allergic to local anaesthetic, antiseptic or latex, have a breast implant (for a breast procedure), or are pregnant or breastfeeding.

• Bring your prescription, previous scan reports and CDs, and any earlier FNAC or biopsy reports.
• Bring a recent clotting test (PT/INR) and platelet count if our team asks for one; if you take warfarin or acenocoumarol (Acitrom), a recent INR is usually needed. The blood sample can also be given at our centre.
• Most people can eat normally beforehand; if fasting is needed, our team will tell you.
• Wear a two-piece outfit; for a neck procedure, leave necklaces at home.

Consent and what happens on the day

The radiologist reviews your prescription and earlier scans, checks the lump on ultrasound and explains the procedure, its risks and any alternatives. Once your questions are answered, you sign a consent form.

• You lie on the couch; for a neck procedure, a pillow under your shoulders tilts your head back a little. To drain fluid from around the lung, you usually sit up and lean forward instead.
• The skin is cleaned and, where needed, numbed with local anaesthetic, which stings for a few seconds.
• Watching the live image, the needle is guided into the lump. For an FNAC it moves gently in and out for a few seconds, and this is usually repeated a few times; during a thyroid FNAC you will be asked not to swallow or talk.
• During a core biopsy the device makes a loud click as each sample is taken; this is expected.
• If you feel faint or light-headed at any point, say so and you can lie flat; this is common and passes quickly.
• Firm pressure is applied for a few minutes, then a small dressing; after a short rest you go home.

Aftercare and warning signs

Keep the dressing clean and dry for about 24 hours. Soreness or a bruise for a few days is common; a cloth-wrapped ice pack helps. For pain, paracetamol is usually suitable unless your doctor has advised otherwise; painkillers such as ibuprofen can increase bruising, but keep taking any prescribed aspirin or blood thinner as your doctor has advised. After a core biopsy, avoid heavy lifting and strenuous exercise for about a day. Contact your doctor or call us if you notice:

• Bleeding that does not stop after 10-15 minutes of firm pressure
• Swelling at the site that keeps increasing
• Fever, or redness, warmth or pus at the site

Your result comes from the laboratory

The slides or tissue go to our partner pathology laboratory, where a pathologist examines them and issues a cytology (FNAC) or histopathology (biopsy) report. This takes longer than a scan report, and special tests such as immunohistochemistry (IHC) add time. Our team will tell you when to expect your result.

Thyroid FNAC reports usually use the Bethesda system, from category I (not enough cells to decide, usually repeated) to VI (cancer cells seen); the middle categories may need a repeat test or further tests. Your referring doctor explains the result alongside your scan and examination. If the result does not fit with how the lump looks on the scan, your doctor may advise a repeat sample or a core biopsy.

Safety, radiation and contrast

Ultrasound uses no radiation and ultrasound-guided sampling needs no contrast dye. Bruising and soreness are common; significant bleeding and infection are uncommon, and the radiologist explains the risks for your particular site before you consent. Draining fluid from around the lung carries a small risk of air leaking around the lung (pneumothorax), hence the emergency advice above.

A small number of deeper targets that ultrasound cannot show clearly are sampled under CT guidance instead. CT uses X-rays, so tell us if you are or might be pregnant. Deeper procedures may need a few hours of fasting and a recent clotting test; our team confirms this when you book. If contrast is needed, a recent kidney function (creatinine) report may be requested, and you must tell us about any allergy and about any diabetes medicines, such as metformin.

FNAC and biopsy at AV Scan, Dadar West

Ground Floor (step-free entrance), Shilpa Apartment, Shankar Ghanekar Marg, Dadar West / Prabhadevi, near Shivaji Park and Siddhivinayak Temple.

• Dr. Avinash Bansal, MD (Radiology), whose work includes FNAC, biopsy and drainage under ultrasound guidance; breast imaging at the centre is reported by Dr. Vaishnavi Bansal, MD (Radiology)
• Ultrasound on the GE Voluson E10 and Philips Affiniti 70G; multi-slice CT when CT guidance is needed
• If your scan was done here, the radiologist already has your images to plan the needle route
• The exact price is confirmed on WhatsApp before your visit
• Cashless with most major insurers and TPAs; empanelled for CGHS, ECHS and MJPJAY
• Open Monday to Saturday 8am-10pm and Sunday 8am-5pm