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A biopsy is the removal of a sample of tissue or cells from the body for examination. A pathologist usually does the examination of the tissue or cells. The tissue or cells are generally examined under a microscope to determine the presence of any abnormality.
A biopsy may be obtained from any part of the body. The part of the body involved in a biopsy depends upon the location of the tumor or inflammation. Common biopsy sites include:
- Bone marrow
- Breast
- Brain
- Gastrointestinal tract
- Kidney
- Liver
- Lung
- Lymph nodes
- Skin
- Thyroid
- Prostate
- Colon
A biopsy is usually performed to determine if the cells from a sample of body tissue are abnormal. A major reason to obtain a biopsy is to rule out cancer. Sometimes biopsies are obtained to determine the cause of an unexplained infection, inflammation, swelling, or growth. Your doctor will discuss the possible risks of any specific biopsy before the procedure. A surgeon in the office or the operating room generally does the biopsy. Depending on where the biopsy is performed, the risks and complications may vary. 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. Your doctor will give you specific instructions. The doctor will numb the area with a local anesthetic before taking the biopsy. If surgery is needed, you will receive a general anesthetic. - 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.
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. A simple biopsy should only take a few minutes, but a biopsy involving general surgery will take longer. After the biopsy, there might be some pain where the tissue or tumor was removed. Your doctor may prescribe medication to relieve the pain. - Bleeding
- Pain
- Infection
- Results that are inconclusive or difficult to interpret
- Negative result or normal result
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. Your doctor will provide care instructions according to the type of biopsy you have. A pathologist will interpret your biopsy. Sometimes, the biopsy tissue has to be sent to specialized centers out of state. Your doctor will inform you of the results.
Common interpretations of biopsies include:
- Normal tissue, no abnormalities
- Not normal, but no cancer (often an inflammation)
- Not normal, but difficult to interpret
- Not normal, not cancerous, but a precancerous condition
- Cancer
- Inconclusive
- Bleeding
- Infection
- Fever
- Redness around the biopsy site
- Drainage from the biopsy site
- Enlargement of the biopsy site
- Worsening of your symptoms
- New symptoms develop and persist
Last reviewed October 2007 by Marcin Chwistek, MD Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition. Copyright © EBSCO Publishing. All rights reserved. |
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