Random Periareolar Fine-Needle Aspiration (RPFNA)

This procedure can help clarify short-term (five-year) risk when used for women already thought to be at increased risk of breast cancer because of family history or other major risk factors. We also use this procedure to determine eligibility and response to a prevention intervention for many of our prevention clinical trials.

Graphic RPFNA involves removing breast cells by inserting a very thin needle into an anesthetized area of the breast. The average discomfort is “1” on a scale of 1 to 10. The procedure is used to give us an idea as to whether there are probably generalized pre-cancerous changes throughout the breast tissue. We give the changes we see a word descriptor as well as a numerical score. If we detect pre-cancerous changes called atypia (scores of 15 to 18), your five-year risk is generally high enough that  you may want to have more frequent surveillance, take a standard prevention drug or consider  becoming  part of a clinical trial.

This procedure is free to participants. It’s funded primarily by philanthropic donations and secondarily by grants from the National Cancer Institute, Komen for the Cure and the Breast Cancer Research Foundation.

You may be eligible for the RPFNA procedure if you have:

  • A mother, sister or daughter (“first-degree relatives”) diagnosed with breast cancer before age 60
  • Prior diagnosis of “atypical hyperplasia or LCIS” by  a breast biopsy
  • Multiple second-degree relatives with breast cancer and at least one of them under age 50
  • Multiple breast biopsies
  • Breast density greater than 50%

You are not eligible if you:

  • Have breast implants
  • Have used a blood-thinning medication such as Coumadin, Heparin, Plavix or Lovenox
  • Are taking a chemotherapy or preventive drug such as tamoxifen (Nolvadex), raloxifene (Evista), letrozole (Famara) or anastrozole (Arimidex)

Here are some forms you may find helpful if you are interested in this test.