When is biopsy necessary




















If a biopsy is carried out during surgery, in some cases a different processing method may be used, known as a frozen section. This enables the surgeon to get a preliminary result, which can be used to help guide treatment while it's in progress. Your GP, hospital consultant or practice nurse will give you your results and explain what they mean. A biopsy is sometimes inconclusive, which means it hasn't produced a definitive result. In this case, the biopsy may need to be repeated, or other tests may be required to confirm your diagnosis.

Page last reviewed: 10 August Next review due: 10 August When a biopsy may be needed A biopsy can be used to investigate abnormalities, which can be: functional — such as kidney or liver problems structural — such as swelling in a particular organ When the tissue sample is examined under the microscope, abnormal cells may be identified, which can help to diagnose a specific condition.

Examples of conditions where a biopsy may be helpful include: cancer inflammation, such as in the liver hepatitis or kidney nephritis infection, such as in lymph nodes — for example, tuberculosis various skin conditions It's not usually possible to tell whether a lump or growth on your skin or inside your body is cancerous malignant or non-cancerous benign by clinical examination alone, which is why a biopsy is often required.

Types of biopsy There are various types of biopsy that can be used to help identify a wide range of health conditions. Different types of biopsy include: a punch biopsy — a special instrument punches a small hole in the skin to obtain a skin sample to investigate a skin condition a needle biopsy — a special hollow needle, guided by X-ray , ultrasound , CT scan or MRI scan , is used to obtain tissue from an organ or from tissue underneath the skin an endoscopic biopsy — an endoscope is used to remove tissue, such as from the stomach during a gastroscopy an excision biopsy — surgery is used to remove a larger section of tissue perioperative biopsy — if consent has been given, a perioperative biopsy can be carried out during surgery; in certain circumstances, the sample may be tested straightaway to help guide the surgery or further treatment How a biopsy is carried out will depend on where the tissue sample is being taken from.

Recovery Most biopsies will only require local anaesthetic , which means you won't need to stay in hospital overnight. Some types of biopsy may involve staying in hospital for a few hours. Doctors use biopsies to test whether abnormalities in your body are caused by cancer or by other conditions.

There are several different kinds of biopsies. Your doctor will choose the type to use based on your condition and the area of your body that needs closer review. Inside some of your larger bones, like the hip or the femur in your leg, blood cells are produced in a spongy material called marrow. If your doctor suspects that there are problems with your blood, you may undergo a bone marrow biopsy. This test can single out both cancerous and noncancerous conditions like leukemia , anemia , infection, or lymphoma.

The test is also used to check if cancer cells from another part of the body have spread to your bones. Bone marrow is most easily accessed using a long needle inserted into your hipbone. The insides of your bones cannot be numbed, so some people feel a dull pain during this procedure.

Others, however, only feel an initial sharp pain as the local anesthetic is injected. Endoscopic biopsies are used to reach tissue inside the body in order to gather samples from places like the bladder , colon, or lung. During this procedure, your doctor uses a flexible thin tube called an endoscope.

The endoscope has a tiny camera and a light at the end. A video monitor allows your doctor to view the images. Small surgical tools are also inserted into the endoscope. Using the video, your doctor can guide these to collect a sample. The endoscope can be inserted through a small incision in your body, or through any opening in the body, including the mouth , nose , rectum , or urethra.

Endoscopies normally take anywhere from five to 20 minutes. Afterward, you might feel mildly uncomfortable, or have bloating , gas, or a sore throat. These will all pass in time, but if you are concerned, you should contact your doctor. Needle biopsies are used to collect skin samples, or for any tissue that is easily accessible under the skin. Most needle biopsies are performed in an outpatient setting with minimal preparation.

When you schedule your biopsy appointment, you will receive detailed instructions about preparation for the biopsy procedure. If you are having a needle or surgical biopsy, ask your health care provider if you need to stop taking any medications before the procedure.

Your doctor may tell you not to eat or drink for eight hours before your biopsy. However, you may take your routine medications with sips of water.

If you are diabetic and take insulin, ask your doctor if you need to adjust your usual insulin dose. Prior to a needle biopsy, tell your doctor about all the medications you take, including herbal supplements. List any allergies, especially to anesthesia. Your doctor may tell you to stop taking aspirin or a blood thinner for a time before your procedure.

Women should always tell their doctor if there is any possibility that they are pregnant. Doctors do not perform some procedures that use image-guidance during pregnancy because radiation can be harmful to the fetus. See the Safety in X-ray, Interventional Radiology and Nuclear Medicine Procedures page for more information about pregnancy and x-rays. You may want to have someone accompany you and drive you home afterward. This will be necessary if you receive sedation.

Preparation for a biopsy procedure will be similar for children. If your child is undergoing a biopsy procedure, the physician will provide you with instructions. There are many different types of biopsy procedures.

The equipment used for each type of biopsy will vary depending on the type of procedure. In needle biopsy, a sample of tissue or fluid is removed with a needle and sent to the laboratory for further analysis. A biopsy needle is generally several inches long. The barrel is about as wide as a large paper clip. The needle is hollow so it can capture the tissue specimen. Doctors perform needle biopsies with the guidance of computed tomography CT , fluoroscopy , ultrasound , or MRI.

A mammography unit is a box with a tube that produces x-rays. The unit is used exclusively for breast x-ray exams and features special accessories to limit x-ray exposure to only the breast. The unit features a device to hold and compress the breast and position it so the technologist can capture images at different angles.

Ultrasound machines consist of a computer console, video monitor and an attached transducer. The transducer is a small hand-held device that resembles a microphone.

Some exams may use different transducers with different capabilities during a single exam. The transducer sends out inaudible, high-frequency sound waves into the body and listens for the returning echoes. The same principles apply to sonar used by boats and submarines. The technologist applies a small amount of gel to the area under examination and places the transducer there.

The gel allows sound waves to travel back and forth between the transducer and the area under examination. The ultrasound image is immediately visible on a video monitor. The computer creates the image based on the loudness amplitude , pitch frequency , and time it takes for the ultrasound signal to return to the transducer.

The CT scanner is typically a large, donut-shaped machine with a short tunnel in the center. You will lie on a narrow table that slides in and out of this short tunnel. Rotating around you, the x-ray tube and electronic x-ray detectors are located opposite each other in a ring, called a gantry. The computer workstation that processes the imaging information is in a separate control room. This is where the technologist operates the scanner and monitors your exam in direct visual contact. The technologist will be able to hear and talk to you using a speaker and microphone.

A vacuum-assisted device VAD is a vacuum-powered instrument that uses pressure to pull tissue into the needle. In some situations, image guidance is used to help a surgeon to perform a surgical biopsy.

A thin guide wire may be placed or marking dye injected with x-ray, ultrasound, or CT guidance to aid the surgeon in locating the correct area for a surgical biopsy. Other sterile equipment that may be involved in a biopsy procedure includes syringes, sponges, forceps, scalpels and a specimen cup or microscope slide. The type of procedure used to perform the biopsy depends on the location of the tissue that needs to be examined.

Most areas of the body can be biopsied with a needle device. This is the least invasive option, and usually allows for the patient to return home the same day. Imaging guidance with x-ray, ultrasound, CT or MRI allows for accurate placement of the needle to locate the best place to take a tissue sample.

In hard to reach places, biopsies using surgery in a hospital operating room may sometimes be necessary. A surgeon will perform surgery to remove the tissue needed for the biopsy. The surgeon may use an instrument with a camera to help locate the best place to biopsy and remove the tissue sample. Using imaging guidance, the doctor inserts the needle through the skin and advances it into the lesion.

Imaging-guided, minimally invasive procedures, such as needle biopsies, are most often performed by a specially trained radiologist, an interventional radiologist or a neuroradiologist.

A nurse or technologist may insert an intravenous IV line into a vein in your hand or arm. This will allow them to provide sedation or relaxation medication intravenously during the procedure.

You may also receive a mild sedative prior to the biopsy. Some biopsies, such as breast or thyroid biopsies, may be performed without sedation.

The nurse or technologist will advise you at the time of the procedure regarding the sedation. When a biopsy is performed on a child, it is more likely that general anesthesia will be required to keep them comfortable during the procedure.

They will use a limited CT or MRI scan to confirm the location of the nodule and the safest approach for the targeted area. The doctor will clean and disinfect the skin around the insertion site and cover it with a clean and sterile drape.

The doctor will make a very small nick in the skin at the site where the biopsy needle will be inserted. Using imaging guidance, the doctor will insert the needle through the skin, advance it to the site of the nodule , and remove samples of tissue. They may need to collect several specimens for complete analysis. Once the biopsy is complete, the doctor will apply pressure to stop any bleeding and cover the opening in the skin with a dressing. No sutures are needed. You may be taken to an observation area for several hours.

The doctor may use X-ray s or other imaging tests to monitor for complications. For stereotactic breast biopsies, you may lie face down or sit up on a moveable exam table and the affected breast or breasts will be positioned into openings in the table.



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