improved design for fine-needle aspiration (fna) of breast cancer lesions

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

Breast Cancer Lesions Breast Cancer Lesions

Alissa GarmanAlissa GarmanJanie GoldsworthyJanie Goldsworthy

Kristi HinnerKristi HinnerNick KortanNick Kortan

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

Midsemester Presentation March 7, 2003Midsemester Presentation March 7, 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

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 Pre-manufactured

drill bitdrill bit

6” length6” length

Fits in 23 gauge Fits in 23 gauge needleneedle

Bead on shaft of drill Bead on shaft of drill bit to allow for ease bit to allow for ease

of turning during cell of turning during cell collectioncollection

Tissues TestedTissues Tested

Fixed cat tissues (Last semester)Fixed cat tissues (Last semester)– MammaryMammary– LymphLymph– FatFat

Fresh tissue Fresh tissue – Mouse Mouse

mammary mammary tumor (cystic)tumor (cystic)

Testing Procedures (Fresh Tissue)Testing Procedures (Fresh Tissue)

Old techniqueOld technique– No insert usedNo insert used– Performed one trial on the mouse tumorPerformed one trial on the mouse tumor

New techniqueNew technique– Drill bit insert usedDrill bit insert used– Performed one trial on the mouse tumorPerformed one trial on the mouse tumor

Observed in saline bath under microscopeObserved in saline bath under microscope

Prepared slides and sent to lab for evaluationPrepared slides and sent to lab for evaluation

Sample QuantificationSample Quantification

Old techniqueOld technique– Resulted in a small Resulted in a small

amount of tissue amount of tissue

New techniqueNew technique– Roughly five times Roughly five times

as much tissue as much tissue collected using drill collected using drill bitbit

Slide PreparationSlide Preparation

Two methodsTwo methods1.1. Air-dry methodAir-dry method

- Place sample on slide and smear using a second - Place sample on slide and smear using a second slideslide

- Results in two identical slides- Results in two identical slides- Stain with Methanol Blue type stain- Stain with Methanol Blue type stain

2.2. ThinPrep methodThinPrep method- Place sample in vile of ThinPrep solution- Place sample in vile of ThinPrep solution- Slide prepared using ThinPrep machine in lab- Slide prepared using ThinPrep machine in lab- $8.00/vile - $8.00/vile

Sample SlidesSample Slides

Benign FNA Cell Sample

Sample SlidesSample Slides

Malignant FNA Cell Samples

Future WorkFuture Work

Test on more freshly sacrificed mouse Test on more freshly sacrificed mouse tumorstumorsHave slides evaluated by pathologistHave slides evaluated by pathologistIn vivoIn vivo testing of mouse tumors- testing of mouse tumors- will will require protocol amendmentrequire protocol amendmentFurther prototype developmentFurther prototype developmentDevelop protocol for quantifying testingDevelop protocol for quantifying testingContinued research on independent Continued research on independent cytopathological evaluationcytopathological evaluation