Biopsy

Prior to Procedure

If the biopsy is performed in the doctor’s office, usually no special preparation is needed for a biopsy. The doctor will numb the site of the biopsy and excise the lesion and most likely close the biopsy site. Sometimes, only a needle is inserted into the area (eg, breast) and cells are obtained (called aspiration biopsy). This usually takes a few minutes and is associated with minimal pain. If you will be having surgery under general anesthesia, you will not be able to eat or drink for several hours before the test.

During Procedure

Your doctor will give you specific instructions.

Anesthesia

The doctor will numb the area with a local anesthetic before taking the biopsy. If surgery is needed, you will receive a general anesthetic.

Description of the Procedure

• Needle biopsy—Cells from a tumor are removed using a thin needle.
• Aspiration biopsy—Cells are drawn out with a hollow needle that uses suction. A computed tomography scan ( CT or CAT scan —a type of x-ray that produces cross-sectional images of the body) may be used to guide the needle into a tumor in an internal organ.
• Core needle biopsy—A sample of tissue is removed using a hollow “core” needle (larger than the needle used in a fine needle aspiration biopsy) that has a special cutting edge. Three to six separate insertions are often made to procure a sufficient sample of tissue. This type of biopsy is typically used to sample soft tissue and bone lesions.
• Vacuum-assisted biopsy—A number of samples of tissue are taken using a special rotating probe device inserted through one small cut. This type of biopsy is typically used to sample breast tissue.
• Endoscopic biopsy—A sample of tissue is removed with a long, thin tube with a lighted camera on one end (endoscope). The endoscope is used to view an organ for abnormalities. It can be inserted into the abdominal cavity ( laparoscopy ), bladder ( cystoscopy ), gastrointestinal tract (alimentary tract endoscopy), joint cavity ( arthroscopy ), mid-portion of the chest (mediastinoscopy), trachea and bronchial system ( laryngoscopy and bronchoscopy ), or chest cavity (thorascopy). Tissue from the tumor is taken using forceps, a brush, or a needle attached to a cable within the endoscope.
• Incisional biopsy—A portion of a tumor is removed by surgical incision. This type of biopsy is used most frequently for tumors of the soft tissues (muscle, fat, connective tissue).
• Excisional biopsy—If the mass is small, it is completely removed. This type of biopsy may be used to examine enlarged lymph nodes, breast lumps, and organs such as the spleen, which could pose dangers if cut without complete removal.
• Punch biopsy —A core of skin (dermis, epidermis, and fat) is removed with a special biopsy instrument. The hole is typically closed with a suture and heals with little scarring. This type of biopsy is typically used to sample skin rashes and small masses.
• Skin biopsy —A small piece of skin is cut off with a scalpel.
• Shave biopsy—Top layers of skin are shaved off with a special blade.
• Stereotactic biopsy—Both core needle biopsy and vacuum-assisted biopsy often rely on stereotactic mammography or ultrasound imaging to determine the location of lesions that cannot easily be felt. The stereotactic procedure uses computer x-rays taken from two different angles to locate the desired cell areas. The resulting coordinate points help the doctor guide the needle or probe to the lesion.
• Bone marrow biopsy—A long needle is inserted into the bone marrow to collect cells. In adults, the sample is usually taken from the back of the pelvic bone (the posterior superior iliac spine) or from the clavicle. The procedure is associated with some discomfort which may last a few hours.

After Procedure

If you have a simple biopsy performed in the physician’s office, you can go home. If your biopsy involved surgery with general anesthesia , you will probably be required to stay at the hospital for one or more days for observation.

To ensure correct results, the results of most biopsies take several days. In the few cases where cells are observed under a microscope, a preliminary result may be obtained in a few minutes.

How Long Will It Take?

A simple biopsy should only take a few minutes, but a biopsy involving general surgery will take longer.

Will It Hurt?

After the biopsy, there might be some pain where the tissue or tumor was removed. Your doctor may prescribe medication to relieve the pain.

Possible Complications

• Bleeding
• Pain
• Infection
• Results that are inconclusive or difficult to interpret
• Negative result or normal result

Average Hospital Stay

A simple biopsy can be done on an outpatient basis. A biopsy that involves surgery will require a hospital stay of one or more days.

Postoperative Care

Your doctor will provide care instructions according to the type of biopsy you have.