This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on June 13, 2022.

A health care provider may recommend a biopsy if an exam or test reveals something suspicious.

This article will cover:

What is a biopsy?

A common way to diagnose most cancers, a biopsy takes a sample of tissue, fluid or a growth of cells from the patient's body. This sample is then sent to a laboratory to be tested and examined for the presence of cancer or other signs of disease.

Breast biopsies, skin biopsies, bone marrow biopsies and liver biopsies are all common types of biopsies used to determine a cancer diagnosis. Other common biopsy sites include the gastrointestinal (GI) tract, bladder, colon and lymph nodes. A biopsy is the only way to diagnose most cancers. Imaging tests like CT scans and X-rays may be used to help identify abnormal areas, but they can’t differentiate between cancerous and noncancerous cells.

What happens during the biopsy procedure?

During the procedure, the doctor or surgeon will take a small sample of tissue from the patient's body. To perform this procedure, the doctor:

  • Places the patient in a comfortable position that allows access to the part of the body being biopsied
  • Sterilizes the area being biopsied and applies a local anesthetic to reduce pain
  • Gives the patient general anesthesia, sedation or relaxation medication intravenously, if needed

Types of biopsies to diagnose cancer

Biopsies are performed in a number of different ways. Deciding which approach is appropriate for each patient depends on the size, shape, location and the actual abnormality.

Many biopsy procedures are categorized by the tool needed to take the sample. Other biopsies are named for the imaging technology used during the procedure. Biopsies may require ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI). Doctors also refer to biopsies by the part of the body being screened for cancer cells.

Bone marrow biopsy

Bone marrow aspiration and biopsy is used to diagnose hematologic cancers—such as leukemialymphoma and multiple myeloma—that may have been detected by abnormal blood work results.

The procedure may also be used for cancers that have spread to bone marrow from another location, like the breast. Bone marrow aspiration and biopsy uses a needle to remove bone marrow fluid, usually from the hip or breastbone, then examining the sample under a microscope.

Endoscopic biopsy

An endoscopic biopsy is performed with an endoscope, a thin, flexible tube with a camera attached. Typically, endoscopy is performed in a radiology suite, but if the doctor needs to sample tissue from deep in the body, the procedure may be performed in a surgical suite.

Types of endoscopic biopsies may include those listed below.

Bronchoscopy: This procedure allows the care team to examine the inside of the patient’s lungs.

Colonoscopy: During this procedure, the care team examines the inside of the colon and rectum.

Cystoscopy: If the care team aims to examine the inside of the bladder and urethra, a cystoscopy may be performed.

Laparoscopy: A laparoscopy allows the care team to examine the inside of the abdomen and pelvis. 

Laryngoscopy: This procedure allows the care team to examine the vocal cords, larynx and other structures in the back of the throat.

Mediastinoscopy: During this procedure, the care team examines the inside of the mediastinum (the area between the patient’s lungs and the back of his or her breastbone).

Thoracoscopy: A thoracoscopy allows the care team to examine the area inside the chest and outside the lungs.

Upper endoscopy: This procedure, which is also referred to as esophagogastroduodenoscopy (EGD), allows the care team to examine the inner lining of the upper digestive tract.

Liquid biopsy

A liquid biopsy analyzes blood or other body fluids rather than tissue. Liquid biopsies may be able to detect markers such as cancer cells, DNA or proteins from cancer cells.

While liquid biopsies may be an important part of the diagnosis and analysis process, the science behind these biopsies is still being perfected. Therefore, liquid biopsies are often combined with other biopsy types as part of a patient’s overall diagnosis plan.

Needle biopsy

During a needle biopsy, the care team inserts a needle through the patient’s skin to remove cells from an area of concern. Several types of needle biopsy procedures are available, as listed below.

Core-needle biopsy: The care team uses a larger hollow needle to remove tissue from the area of concern.

Fine-needle aspiration biopsy: The care team uses a thin, hollow needle to extract cells and fluid from the suspicious area.

Image-guided biopsy: During this procedure, the biopsy procedure occurs with the assistance of imaging to ensure that the needle is directed to the most precise location.

  • CT-guided biopsy combines a CT scan with a biopsy, inserting a needle into the body to obtain a tissue sample. The X-ray is used to provide detailed images of the biopsy area, allowing for more accuracy in placing the needle.
  • MRI-guided breast biopsy uses MRI technology to confirm the location of the tumor, helping the radiologist guide the core needle’s placement into the tumor and remove tissue from the breast.

Vacuum-assisted biopsy: The care team applies a suctioning device to help remove more cells and fluid through the needle to retrieve a sufficient size sample for analysis.

Skin biopsy

During a skin biopsy, the care team extracts cells from the body’s surface to evaluate whether any abnormal cells are present. Several types of skin biopsy are performed, as listed below.

  • An excisional biopsy involves removing an entire lump or lesion.
  • An incisional biopsy only involves taking a small sample of tissues from a tumor.
  • A punch biopsy uses a circular tool that punches a round hole in the skin.
  • A shave biopsy uses a small blade or razor.

Surgical biopsy

A surgical biopsy allows the care team to remove cells from an area of concern by cutting into the skin and other tissue with a scalpel. Types of surgical biopsy include those listed below.

Sentinel lymph node biopsy helps doctors determine whether cancer has spread. In this procedure, dye is injected into the tumor. The first lymph node (or nodes) to absorb the dye are considered sentinel, because they are the first to which the cancer is most likely to spread from a primary tumor. The surgeon removes the sentinel lymph nodes, and the pathologist then tests samples for the presence of cancer. If the testing determines that the cancer has spread, more lymph nodes may be removed. Sometimes, this biopsy is performed while the primary tumor is being removed. This type of biopsy is commonly performed on breast tumors or or melanoma.

Breast biopsy allows the care team to find out more about the breast cells. During this procedure, the care team removes a small sample of breast tissue for further analysis.

Preparing for a biopsy

Before the biopsy, tell the doctor:

  • If the patient is pregnant or allergic to latex
  • Which medications the patient is taking, including over-the-counter drugs
  • If the patient takes any vitamins, supplements or herbal remedies

Depending on the type of biopsy being performed, the care team may advise the patient to take additional steps to prepare for the procedure, such as fasting a certain number of hours beforehand or discontinuing medications.

The patient will also likely be asked to leave jewelry at home and wear loose-fitting, comfortable clothing, or when appropriate, a gown. The procedure may take place in a doctor's office, radiology suite or surgical suite, depending on the type of biopsy being performed.

How long do biopsy results take?

The care team will work to deliver results of the pathology report as quickly as possible, so the patient can make informed decisions about the road ahead. The biopsy results are typically returned in one to three days, depending on the sample and blood tests. The patient's doctor will thoroughly explain the results, and if necessary, recommend follow-up tests or treatments.

If the incision site requires stitches, the care team may have to remove them, usually a week to 10 days after the biopsy.

What are the risks of undergoing a biopsy?

The care team will take the time to discuss with patients each procedure, explaining how it’s performed, any risks involved and answering other questions they may have.

Generally speaking, any procedure that involves cutting into the skin comes with some risk. However, biopsies require only small incisions, especially in needle biopsies, so the risks are typically lower than for more invasive procedures. Risks may include those listed below.

Pain: The patient may experience some minor pain at the incision site. Contact the doctor if severe pain occurs after the biopsy.

Infection: Talk to the doctor if redness, swelling or drainage occur in the area the biopsy was performed, or if the patient develops a fever after the procedure. These may be signs of infection.

Excessive bleeding: Bleeding, if any, is typically minimal, especially because the incision is small, but in some rare cases, patients may experience heavier bleeding or bleeding that doesn’t stop. Contact the physician if the incision site bleeds for longer than expected or if it does not heal.

Allergic reactions: The antibiotic, numbing gel, or bandages used in biopsies may cause allergic reactions to the skin. Talk to the doctor if redness or itching occur at the biopsy site.

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