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Biopsy

Definition

A biopsy is the removal of a sample of tissue or cells. A pathologist examines the sample under a microscope.

A biopsy may be taken from any part of the body.

Reasons for Procedure

A biopsy is used to see if the cells from a sample of tissue are abnormal. Often, a biopsy is done to rule out cancer and/or to specify its type and level of aggressiveness.

Biopsies are sometimes taken to find out the cause of an unexplained:

  • Infection
  • Swelling
  • Growth

Common interpretations of biopsies include:

  • Normal tissue, no abnormalities
  • Irritated tissue
  • Not normal, but difficult to interpret
  • Not normal, not cancerous, but a precancerous condition
  • Cancer
  • Inconclusive

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have a biopsy, your doctor will review a list of possible complications, which may include:

  • Bleeding
  • Pain
  • Infection
  • Scarring
  • Results that are difficult to interpret

Factors that may increase the risk of complications include:

Be sure to discuss these risks with your doctor before the surgery.

What to Expect

Prior to Procedure

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

  • Anti-inflammatory drugs (eg, aspirin)
  • Blood thinners, like clopidogrel (Plavix) or warfarin (Coumadin)

If you will be having general anesthesia, avoid eating or drinking after midnight.

Anesthesia

The type used depends on what you are having biopsied:

  • General anesthesia—blocks pain and keeps you asleep through the procedure; given through an IV in your hand or arm
  • Local anesthesia—just the area that is being operated on is numbed; given as an injection

Description of the Procedure

For a simple biopsy, the area will be cleaned. A numbing medicine will be injected into the area so that you will not feel pain. A piece of tissue or skin will then be removed. The opening will be closed.

The procedure that your doctor uses depends on the type of biopsy that you are having. For example:

  • Needle biopsy—cells are removed using a thin needle
  • Aspiration biopsy—cells are drawn out with a hollow needle that uses suction
  • Core needle biopsy—a sample of tissue is removed using a hollow “core” needle that has a special cutting edge
  • Vacuum-assisted biopsy—a number of samples of tissue are taken using a special rotating probe device
  • Endoscopic biopsy—abnormality is viewed with a long, thin tube that has a lighted camera on one end (called an endoscope); a tool is passed through the tube to take the biopsy sample
  • Incisional biopsy—a portion of a mass is removed by cutting it out
  • Excisional biopsy—a mass is completely removed (eg, breast lump)
  • Punch biopsy—a core of skin is removed with a special biopsy tool
  • 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
  • Bone marrow biopsy—a long needle is inserted into the bone marrow to collect cells

Bone Marrow Biopsy

Bone Biopsy pelvis

© 2011 Nucleus Medical Media, Inc.

How Long Will It Take?

A simple biopsy usually takes a few minutes. A biopsy involving surgery takes longer.

How Much Will It Hurt?

You will have pain in the area where the sample was removed. Your doctor may give you pain medicine.

Average Hospital Stay

If you have a simple biopsy, you will be able to go home. If your biopsy involved surgery, you may need to stay in the hospital for 1-2 days.

Post-procedure Care

Be sure to follow your doctor's instructions.

  • Take pain medicine as directed by your doctor.
  • To relieve discomfort, apply a warm compress or a heating pad to the area.
  • Ask your doctor when you should change the bandages.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • If you have stitches, have them removed in about a week.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the biopsy site
  • Signs of infection, including fever and chills
  • Bleeding
  • Pain that you cannot control with the medicines you have been given
  • Any new symptoms

In case of an emergency, CALL 911.

RESOURCES:

American Cancer Society
http://www.cancer.org/

National Library of Medicine
http://www.nlm.nih.gov/

CANADIAN RESOURCES:

BC Cancer Agency
http://www.bccancer.bc.ca/

Health Canada
http://www.hc-sc.gc.ca/index-eng.php/

References:

Biopsy. Radiology Info website. Available at: http://www.radiologyinfo.org/en/sitemap/modal-alias.cfm?modal=biop. Accessed July 24, 2009.

Biopsy procedures used to diagnose cancer. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/biopsy/CA00083. Updated April 2009. Accessed July 24, 2009.

Diagnosis. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/wyntk/overview/page7. Accessed July 24, 2009.

Schoonjans JM, Brem RF. Fourteen-gauge ultrasonographically guided core-needle biopsy of breast masses. J Ultrasound Med. 2001;20:967-972.

6/3/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.



Last reviewed September 2010 by Lawrence Frisch, MD, MPH


Last updated Updated: 6/3/2011

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.


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