Biopsy

Your health care provider may recommend a biopsy if an exam or test reveals something suspicious. A common way to diagnose most cancers, a biopsy takes a sample of tissue, fluid or a growth of cells from your body. This sample is then sent to a laboratory to be tested and examined for the presence of cancer or other signs of disease.

What happens during the biopsy?

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

• Place you in a comfortable position that allows access to the part of your body being biopsied
• Sterilize the area being biopsied and apply a local anesthetic to reduce pain
• Give you general anesthesia, sedation or relaxation medication intravenously, if needed

How are biopsies performed?

• An excisional biopsy involves removing an entire lump or lesion, whereas an incisional biopsy only involves taking a small sample of tissues from a tumor.
• Many biopsy procedures are categorized by the tool needed to take the sample:
  • A surgical biopsy uses a scalpel.
  • Fine-needle aspiration biopsy uses a thin, hollow needle.
  • A core-needle biopsy uses a larger hollow needle.
  • A punch biopsy uses a circular tool that punches a round hole in the skin.
  • A shave biopsy uses a small blade or razor.
  • An endoscopic biopsy is performed with an endoscope, a thin, flexible tube with a camera attached. Typically, endoscopy is performed in the radiology suite, but if the doctor needs to sample tissue from deep in the body, the procedure may be performed in a surgical suite.

• Other biopsies are named for the imaging technology used during the procedure. Biopsies may require ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI).
  

  • 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.

• Doctors also refer to biopsies by the part of the body being screened for cancer cells. For example:
  • Bone marrow aspiration and biopsy is used to diagnose hematologic cancers—such as leukemia, lymphoma 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 requires using a needle to remove bone marrow fluid, usually from the hip or breastbone, then examining the sample under a microscope.
    
    
  • Sentinel lymph node biopsy helps doctors determine whether the 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 need to 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 melanoma.

Preparing for your biopsy

• If you are pregnant or allergic to latex
• What medications you’re taking, including over-the-counter drugs
• If you take any vitamins, supplements or herbal remedies

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

You 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.

When will I know the results?

At City of Hope, your care team will work to deliver results of the pathology report as quickly as possible, so you 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. Your doctor will thoroughly explain the results to you, and if necessary, recommend follow-up tests or treatments.

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

What are the risks of undergoing a biopsy?