In some cases, your doctor may decide that he or she needs a sample of your tissue or your cells to help diagnose an illness or identify a cancer. This removal of tissue or cells is called a biopsy.
While a biopsy may sound scary, it’s important to remember that most are entirely pain-free and low-risk procedures. Depending on your situation, a piece of skin, tissue, organ, or suspected tumor will be removed—usually surgically—and sent to a lab for testing.
Why a Biopsy Is Done
If you have been experiencing symptoms normally associated with cancer, and your doctor has located an area of concern, he or she may order a biopsy to help determine if that area is cancerous.
A biopsy is the only sure way to diagnosis most cancers. Imaging tests—such as CT scans and X-rays—can help identify areas of concerns, but they cannot differentiate between cancerous and noncancerous cells.
Biopsies are typically associated with cancer, but just because your doctor orders a biopsy, it doesn’t mean that you have cancer. Doctors use biopsies to test whether abnormalities in your body are caused by cancer or by other conditions.
For example, a woman might have a lump in her breast. An imaging test would confirm the lump, but a biopsy is the only way to determine whether it is breast cancer or another noncancerous condition, such as polycystic fibrosis.
Types of Biopsies
There are several different kinds of biopsies. Your doctor will choose the type to use based on your own condition and the area of your body that needs closer review.
Whatever the type, you’ll be given local anesthesia to numb the area where the incision is made.
Bone Marrow Biopsy
Inside some of your larger bones—such as the hip or the femur in your leg—blood cells are produced in a spongy material called marrow.
If your doctor suspects there are problems with your blood, you may undergo a bone marrow biopsy. This test can single out both cancerous and noncancerous conditions, such as 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. This may be done in a hospital or doctor’s office. 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 him or her to view the images. Small surgical tools are also inserted into the endoscope, and—using the video monitor—the 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.
This procedure can be done in a hospital or in a doctor’s office. 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. The different types of needle biopsies include:
- core needle biopsies use medium-sized needle to extract a column of tissue, in same way that core samples are taken from the earth
- fine needle biopsies use a thin needle that is attached to a syringe, allowing fluids and cells to be drawn out
- image guided biopsies are guided with imaging procedures—such as X-ray or CT scans—so your doctor can access specific areas, such as the lung, liver, or other organs
- vacuum-assisted biopsies use suction from a vacuum to collect cells
The Risks of a Biopsy
Any medical procedure that involves breaking the skin carries the risk of infection or bleeding. However, as the incision is small—especially in needle biopsies—the risk is much lower.
How to Prepare for a Biopsy
Biopsies require no preparation on the part of the patient. However, if you have a problem with needles, you should talk to your doctor or nurse practitioner about ways to ease your anxiety.
As always before a medical procedure, tell your doctor what medications and supplements you take. You may need to stop taking certain drugs before a biopsy, such as aspirin or non-steroidal anti-inflammatory medications.
Following Up After a Biopsy
After the tissue sample is taken, your doctors will need to analyze it. In some cases, this analysis can be done at the time of procedure. More often however, the sample will need to be sent to a laboratory for testing. The results can take anywhere from a few days to a few weeks.
Once the results arrive, your doctor may call you to share the results, or ask you to come in for a follow-up appointment to discuss the next steps.
If the results showed signs of cancer, your doctor should be able to tell the type and the cancer’s level of aggression from your biopsy. He or she will use those results to prepare a treatment course for you.
If the results are negative, you’re in luck—it’s not cancer. Your doctor will probably still want to follow up. Your biopsy might have shown a different clear-cut problem that needs treatment. If not, your doctor will need to do other tests to identify the causes of the problems that brought you to the office in the first place.