Wide Core Needle Biopsy of a Lymph Node

This leaflet is to provide you with information on having a Wide Core Needle Biopsy (WCNB). This leaflet is not intended to replace the discussion between you and the doctor and healthcare team, but may act as a starting point for discussion.

What is a WCNB?

The doctor has recommended that you have a WCNB of a lymph node in the armpit because an abnormality has been found in your breast. The WCNB procedure is a simple method of obtaining a sample of the lymph node which can then be looked at under a microscope to obtain a diagnosis.

The WCNB can be carried out using ultrasound and an injection of ultrasound contrast to pin point the lymph node to be tested. 

This procedure will enable a small sample of the lymph node to be sent to the Pathology department to be examined under a microscope and provide a diagnosis for your doctor.

Is there an alternative procedure?

 An alternative method of removing a sample of lymph node is a vacuum assisted breast biopsy – this test removes a larger sample of lymph node using a vacuum method.

The doctor will decide with you which is the best method for you.

How is a WCNB done?

You do not need any special preparation before having a WCNB.

The procedure should not be painful. You will be given an injection of local anaesthetic; there will be some stinging at first but after this the area will become numb.  Sometimes a tiny metallic marker is placed in the breast to mark the area where the lymph node biopsy was taken.  The doctor will tell you if this is going to happen, you will not be able to feel the marker and it will not affect you in any way in the future.  

The biopsy needle makes a loud clicking noise when the biopsy is taken, the doctor will let you hear this noise before taking the biopsy so you are not surprised by it. You may feel some pressure in your armpit as the biopsy is taken and staff will check regularly that you are comfortable and not feeling pain. The doctor may take several biopsies from the area. This is nothing to be concerned about and is normal practice.

You must let staff know if you are taking a blood thinning medication such as warfarin or clopidogrel or if you are taking daily aspirin.

In these circumstances you will be advised by the doctor of the correct preparation before you are given an appointment for this procedure.

Are there any risks?

This is a simple procedure and there are no known serious risks or complications associated with it.

Occasionally the sample taken will not provide a diagnosis e.g. it may not contain any of the tissue that the doctor wants to look at, there may not be enough lymph node to test, or the results of the pathology tests may be uncertain.

In this situation the doctor will discuss the options available to you.

What happens after the procedure?

After the procedure the nurse will apply a dressing to the biopsy area, this can be removed after 24 hours.

You may bath and shower as usual, any discomfort you have following the procedure can be relieved by wearing a firm supportive bra and taking a mild painkiller such as paracetamol, unless you have an allergy to this medicine. 

Please do not take aspirin as this may cause more bleeding and bruising.

Most women feel fine after the procedure and are able to resume normal activities. However we would recommend that you avoid strenuous exercise for at least 24 hours following the biopsy. If possible it is best to go home and put your feet up and relax for a few hours after the procedure.

If the area becomes inflamed or you are concerned please contact the Breast Unit for advice on:

0191 4453747 Monday to Friday 9.00am to 5.00pm 

Out of hours please contact NHS Direct on 111

If you have any feedback please contact the Superintendent Radiographer on 0191 445 3775

Data Protection

Any personal information is kept confidential.  There may be occasions where your information needs to be shared with other care professionals to ensure you receive the best care possible.

In order to assist us to improve the services available, your information may be used for clinical audit, research, teaching and anonymised for National NHS Reviews and Statistics.  

Further information is available via Gateshead Health NHS Foundation Trust website or by contacting the Data Protection Officer by telephone on 0191 445 8418 or by email ghnt.ig.team@nhs.net.