Improved Design for Improved Design for Fine-Needle Aspiration (FNA) of Fine-Needle Aspiration (FNA) of

Breast Cancer Lesions Breast Cancer Lesions Alissa GarmanAlissa Garman

Janie GoldsworthyJanie GoldsworthyKristi HinnerKristi HinnerNick KortanNick Kortan

Client: Elizabeth BurnsideClient: Elizabeth BurnsideAdvisor: John WebsterAdvisor: John Webster

Final Presentation May 2, 2003Final Presentation May 2, 2003

Problem StatementProblem Statement

GOAL:GOAL: To modify the needle used during a To modify the needle used during a Fine Needle Aspiration (FNA) procedure. Fine Needle Aspiration (FNA) procedure. The modification should not drastically The modification should not drastically change the FNA procedure and still change the FNA procedure and still increase the amount of tissue removed for increase the amount of tissue removed for cytological testing. It should also minimize cytological testing. It should also minimize the time (by collecting an adequate sample the time (by collecting an adequate sample size on the first attempt) and discomfort size on the first attempt) and discomfort caused to the patient during the procedurecaused to the patient during the procedure. .

What is FNA?What is FNA?

Technique used to Technique used to extract cells; no extract cells; no incision neededincision neededSeveral insertions are Several insertions are usually required to usually required to ensure an adequate ensure an adequate sample sizesample sizeSamples are sent to Samples are sent to pathologist to be pathologist to be analyzedanalyzed National Breast Cancer Center,

http://www.NBCC.org

When does FNA not work?When does FNA not work?

Approximately 15% of trialsApproximately 15% of trials– Dense, fibrotic, lobular tissue masses Dense, fibrotic, lobular tissue masses

can prevent sufficient sample from can prevent sufficient sample from conventional techniqueconventional technique

Drill bit design could be as a backup in Drill bit design could be as a backup in such casessuch cases

Fine Needle Aspiration (FNA)

A.D.A.M., http://www.adam.com

Product Design SpecificationsProduct Design Specifications

Removes adequate number of cells for Removes adequate number of cells for diagnosis.diagnosis. Should not cause more discomfort than Should not cause more discomfort than current FNA procedure.current FNA procedure. Constrained to standard 20-25-gauge Constrained to standard 20-25-gauge needle, client prefers 23-gauge.needle, client prefers 23-gauge.

Current PrototypeCurrent Prototype

Pre-manufactured drill bitPre-manufactured drill bit6” length6” lengthFits in 23 gauge needleFits in 23 gauge needle

Tissues TestedTissues Tested

Fixed cat tissues (previous semester)Fixed cat tissues (previous semester)– MammaryMammary– LymphLymph– FatFatLiving Tissues (this semester)Living Tissues (this semester)

– Mouse cystic and solid tumorsMouse cystic and solid tumors

Testing ProceduresTesting Procedures

Old techniqueOld technique– No insert usedNo insert used– Performed multiple trials on all tissuesPerformed multiple trials on all tissuesNew techniqueNew technique– Introducer followed by drill bitIntroducer followed by drill bit– Performed multiple trials on all tissuesPerformed multiple trials on all tissues

Sample QuantificationSample Quantification

Old techniqueOld technique– 15 % of trials resulted in either a mass of cells 15 % of trials resulted in either a mass of cells

or a minimal quantity of cells or a minimal quantity of cells New techniqueNew technique– More dispersed cell sampleMore dispersed cell sample– Similar number of cells on averageSimilar number of cells on average– May be easier technique for novicesMay be easier technique for novices– May be used as back-up to conventional May be used as back-up to conventional

techniquetechnique

Future WorkFuture Work

Further prototype developmentFurther prototype developmentResearch into appropriate materials to be Research into appropriate materials to be used (stainless steel, Co-Cr, Ti)used (stainless steel, Co-Cr, Ti)Develop protocol for quantifying testingDevelop protocol for quantifying testingTest on freshly removed fibrotic Test on freshly removed fibrotic (pancreatic) tissue(pancreatic) tissueHuman trialsHuman trialsCytological evaluationCytological evaluationJournal publicationJournal publication

Sample SlidesSample Slides

Benign FNA Cell Sample

Sample SlidesSample Slides

Malignant FNA Cell Samples

Drill Bit Size ComparisonDrill Bit Size Comparison