Random Periareolar Fine Needle Aspiration (RPFNA)

For women who qualify and are interested, we offer a risk stratification procedure called the random periareolar fine needle aspiration (RPFNA).  As part of the procedure, breast cells are removed through a very thin needle under local anesthetic.  We then look at the cells on a slide and may perform other tests as well.  This test is not designed to detect a small cancer, rather provide an overview or “snapshot” of the changes occurring throughout the breast tissue.  If precancerous changes (called atypia) are detected, the woman has a substantial increase in her five-year risk for cancer such that she may need to consider more frequent surveillance, standard risk reduction therapy or a clinical trial.    RPFNA is a relatively painless procedure given the average discomfort score is 1 on a 0-10 scale.

The RPFNA procedure is paid for by grants from foundations, the National Cancer Institute and donations from individuals.  There is no cost to the patient.

Who is eligible?

Women who meet any of the following criteria are potentially eligible:

• First-degree relative (i.e. mother, sister or daughter) who had a breast cancer diagnosis before the age of 60
• Prior diagnosis of atypical hyperplasia carcinoma in situ determined by a breast biopsy
• Previous node-negative breast cancer
• Multiple second-degree relatives who had a breast cancer diagnosis with at least one diagnosis under the age of 50
• Multiple breast biopsies
• Breast density greater than 50%

Conditions for ineligibility:

• Breast implants
• The use of a blood-thinning medication
  • Coumadin, Heparin, Plavix, Lovenox
• Taking a chemotherapy or chemopreventative
  • Tamoxifen (Nolvadex), Raloxifene (Evista), Letrozole (Famara) or Anastrozole (Arimidex for a year or more

Checklists

Pre-menopausal RPFNA Checklist --- PDF version

Post-menopausal RPFNA Checklist --- PDF version

RPFNA Post-Procedure Instructions --- PDF version