Biopsy

What is it?

A biopsy is a procedure that removes a small amount of tissue for examination in a laboratory. Biopsies are done to diagnose many diseases, especially cancer. In some cases, biopsies help to determine prognosis and appropriate treatment. There are different biopsy techniques, depending on which tissue or organ is being sampled.

• Skin biopsy — A sample of skin tissue is removed with a scalpel or punch tool.
• Fine-needle aspiration — A very thin needle is inserted into an organ. Often the procedure is accompanied by ultrasound or computed tomography (CT) scanning to make sure that the needle is in the correct location. The needle is attached to a syringe. The doctor pulls back on the plunger to suck cells from the organ into the empty syringe. The cells are spread on a slide and sent to a laboratory.
• Core needle biopsy — A larger needle with a cutting edge is used to take a full tissue sample, rather than just sucking out cells. A core biopsy gives more information than a fine-needle biopsy.
• Open biopsy — Requires an incision in the skin. Depending on the depth of the body part to be biopsied, the complexity of the procedure varies. For example, a biopsy of an enlarged lymph node in the neck requires only a local anesthetic and often can be done in a doctor's office. Open biopsy of a lung or abdominal structure has to be done in an operating room under general anesthesia.
• Endoscopy procedures — An instrument attached to the end of an endoscope, such as those used in bronchoscopy or colonoscopy, is used to remove a tissue sample.

Biopsies can take as little as a minute for a simple skin biopsy or up to an hour or more for deep biopsies.

What it's used for

A biopsy procedure removes sample bits of tissue or cells to be checked in a laboratory for microscopic signs of cancer or other diseases. In the lab, the biopsy sample is stained and examined under the microscope. This examination can tell whether the tissue sample is normal, not cancerous (benign) or is cancerous (malignant). The laboratory examination can identify the type of cancer, and may be used to evaluate the chance that cancer has spread to other parts of the body. For some types of cancer, new laboratory techniques test biopsy samples for other features of the cells, such as genetic changes. This information can be used to make a more precise diagnosis and plan more individualized therapy.

Preparation

A biopsy also can identify the causes of inflammations and infections.

Because there are several different types of biopsy procedures, your preparation will depend on your specific biopsy. For a skin biopsy, for example, you usually won't need to change what you eat or drink beforehand. However, for an open biopsy that requires general anesthesia, you will need to stop eating and drinking at least several hours before the procedure. If you are scheduled for a colonoscopy and possible colon biopsy, you will take laxatives and enemas according to your doctor's directions, and will have to modify your diet.

In general, even for a minor skin biopsy, it is helpful to remind your doctor about your allergies, your history of surgical procedures and your list of current medications, especially aspirin and blood-thinning medicines. If you are a woman and there is a possibility that you might be pregnant, tell your doctor before you have a biopsy.

How it's done

In a skin biopsy, the area to be biopsied is numbed with a local anesthetic and thoroughly cleaned. Then a small piece of tissue is cut away using a sterile scalpel. Finally, the small wound is stitched closed.

In a needle biopsy, the biopsy area is numbed and cleaned, and a sterile hollow needle is inserted through the skin to take the sample.

In an endoscopic biopsy, a small sharp pinching instrument (forceps) at the end of the endoscope is used to snip off and remove a small tissue sample.

In an open biopsy under general anesthesia, a sample of tissue can be cut directly from an organ that has been exposed with a surgical incision.

Follow-up

While some biopsy results are available rather quickly, others may take a few days. Ask your doctor when to call you should call for your biopsy result.

Risks

Most small biopsy procedures are very safe and carry only a small risk of bleeding or infection at the biopsy site. For larger open biopsies, there are additional risks that accompany general anesthesia and larger surgical procedures.

When to call a professional

After any biopsy procedure, call your doctor if you develop a fever or if you have pain, swelling, redness, pus or bleeding at the biopsy site or at the site of the surgical wound. If you have had an open biopsy, your doctor will tell you what other signs to watch for, depending on the specific type of surgery you had.

Additional info

National Library of Medicine (NLM)
https://www.nlm.nih.gov/